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NPI Code Detail

MEDICARE: LOLITA MOORE RN

MEDICARE: LOLITA MOORE RN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163WI0500XInfusion Therapy Registered Nurse275999AZ
2163W00000XRegistered Nurse654769CA

General Provider Information

NPI Number : 1144929183
Entity Type Code : Individual
Provider Name (Legal Business Name) : LOLITA MOORE RN
Provider Business Mailing Address
First Line : 3527 E ARABIAN DR
Second Line :
City : GILBERT
State : AZ
Zip : 85296-0647
Country : US
Telephone Number : 310-634-2590
Fax Number :
Provider Business Practice Location Address
First Line : 6991 E CAMELBACK RD STE D300
Second Line :
City : SCOTTSDALE
State : AZ
Zip : 85251-2492
Country : US
Telephone Number : 310-634-2590
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/28/2023
Last Update Date : 02/28/2023

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Directions to “ LOLITA MOORE RN” Practice Location

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