Whalio Doctors

NPI 1558829382

Monte Dale Moore, APRN

Practitioner Child & Family Psychiatric/Mental Health Clinical Nurse Specialist Ruston, LA

Practice location

Address
401 E Vaughn Ave, Ruston, LA 71270-5950
Phone
(318) 224-7190
Mailing address
PO Box 1288, Winnfield, LA 71483-1288

Registered specialties

Child & Family Psychiatric/Mental Health Clinical Nurse Specialist Primary
Physician Assistants & Advanced Practice Nursing Providers Taxonomy 364SP0810X Licence 203896 (LA)

Registry record

NPI
1558829382
Entity type
Individual
Sex (as registered)
Male
NPI issued
11 Mar 2019
Record last updated
26 Jun 2019

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.