Doctor Name: | SHERRY M MOORE |
NPI Number: | 1467567255 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | CFNP |
License Number: | APN05064 |
Business Practice Address: | One Prime Care Drive Selmer, TN - 38375 |
Business Phone Number: | 7316457932 |
Business Fax Number: | 7316455195 |
Mailing Address: | One Prime Care Drive, Prime Care Medical Center SELMER |
State: | TN |
Postal Code: | 38375 |
Phone Number: | 7316457932 |
Fax Number: | 7316455195 |
NPI Enumeration Date: | 08/20/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | APN05064 |
Healthcare Provider Taxonomy: (Secondary) | X |
State: | TN |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |