Most Relevant Information
Provider Data
| NPI Number: | 1003565409 |
| Provider Name: | LISA RENEE MOORE LPN |
| Entity Type: | Individual |
| Taxonomy Code: | 164X00000X |
| Specialty: | Licensed Vocational Nurse |
| License Number: | 39468 |
Most Important Dates
| Enumeration Date: | 03/22/2022 |
| Last Updated: | 03/22/2022 |
Provider Practice Location
184 HOLIDAY HILLS DR
PARKERSBURG
WV
261048006
Practice Location Phone/Fax
| Phone: | 3044242400 |
| Fax: | 3044209014 |
Provider Mailing Location
184 HOLIDAY HILLS DR
PARKERSBURG
WV
261048006
Provider Mailing Phone/Fax
| Phone: | 3044242400 |
| Fax: | 3044209014 |