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Raushon Moore, LPN

Licensed Practical Nurse in Flushing, MI. Individual provider (NPI-1).

NPI number1982309605
StatusActive
Last updated in NPPESApr 3, 2023

Details

NPI
1982309605
Entity type
Individual (NPI-1)
Name
Raushon Moore
Credential
LPN
Sex
Male
Sole proprietor
Yes
Enumeration date
Apr 3, 2023
Certification date
Apr 3, 2023
Last updated
Apr 3, 2023

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
164W00000X Licensed Practical Nurse4703126077MIYes

Practice location

2521 N Elms Rd
Flushing, MI 48433-9423

Phone 866-498-3909

Mailing address

2521 N Elms Rd
Flushing, MI 48433-9423

Phone 866-498-3909

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