| Doctor Name: | SANDY MOORE |
| NPI Number: | 1063838803 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RN |
| License Number: | 81304 |
| Business Practice Address: | 109 W Main St Moncks Corner, SC - 294612673 |
| Business Phone Number: | 8437194608 |
| Business Fax Number: | 8437194656 |
| Mailing Address: | 109 W Main St, MONCKS CORNER |
| State: | SC |
| Postal Code: | 294612673 |
| Phone Number: | 8437194608 |
| Fax Number: | 8437194656 |
| NPI Enumeration Date: | 03/17/2014 |
| NPI Last Update Date: | 03/17/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WC1500X |
| License Number: | 81304 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | SC |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Community Health |
| Taxonomy Definition: | |