Provider Demographics
NPI:1679601934
Name:MOREE, JUNE POWELL (APRN, BC)
Entity Type:Individual
Prefix:MS
First Name:JUNE
Middle Name:POWELL
Last Name:MOREE
Suffix:
Gender:F
Credentials:APRN, BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3807 CLAIRMONT RD
Mailing Address - Street 2:
Mailing Address - City:CHAMBLEE
Mailing Address - State:GA
Mailing Address - Zip Code:30341-4911
Mailing Address - Country:US
Mailing Address - Phone:770-457-5867
Mailing Address - Fax:770-451-8018
Practice Address - Street 1:3807 CLAIRMONT RD
Practice Address - Street 2:
Practice Address - City:CHAMBLEE
Practice Address - State:GA
Practice Address - Zip Code:30341-4911
Practice Address - Country:US
Practice Address - Phone:770-457-5867
Practice Address - Fax:770-451-8018
Is Sole Proprietor?:No
Enumeration Date:2007-03-01
Last Update Date:2010-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN030220364SP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0809XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Adult
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAS62852Medicare UPIN