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General NPI Number Information
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NPI Number | 1144929183
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Entity Type | Individual
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Provider Name | LOLITA MOORE RN
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Gender | Female
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Dates
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Enumeration Date | 02/28/2023
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Last Update Date | 02/28/2023
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Provider Practice Location Address
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Address Line | 6991 E CAMELBACK RD STE D300
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City | SCOTTSDALE
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State | AZ
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Zip | 85251-2492
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Country | US
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Telephone | 310-634-2590
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Fax |
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Provider Business Mailing Address
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Address Line | 3527 E ARABIAN DR
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City | GILBERT
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State | AZ
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Zip | 85296-0647
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Country | US
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Telephone | 310-634-2590
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WI0500X
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Taxonomy Name | Infusion Therapy Registered Nurse
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License Number | 275999
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 654769
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License Number State | CA
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