NPI 1104811215

Jill M Moore, FNPBC

Practitioner Family Nurse Practitioner Vassar, MI

Practice location

Address: 1212 W Saginaw Rd, Vassar, MI 48768-9483
Phone: (989) 823-5020
Fax: (989) 823-7881
Mailing address: PO Box 779, Tawas City, MI 48764-0779

Registered specialties

Family Nurse Practitioner Primary

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 363LF0000X Licence 4704173083 (MI)

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Registry record

NPI: 1104811215
Entity type: Individual
Sex (as registered): Female
NPI issued: 14 Sep 2005
Record last updated: 6 Apr 2021

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.