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Contact Information

RAVEN O MOORE, MSN, RN
1333 RIDGE WAY DR
MANDEVILLE, LA70471-7461
 Phone: 225-328-1665
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Family

363LF0000X 50 Nurse Practitioner
 

Diabetes Educator

163WD0400X
Indicates primary specialty

NPI Profile & details for RAVEN O MOORE · (Female)

NPI # 1073296257
Status Active
Credentials MSN, RN
Entity Individual
Enumeration date 08/14/2023
Last updated 01/27/2024 - About 2 years ago
Sole proprietor 1 Yes
Identifiers
  • LA License # 234256
  • LA License # RN110443
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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