| Doctor Name: | AMANDA DAVIS MOORE |
| NPI Number: | 1932463288 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MSN, APRN, ANP-C |
| License Number: | TAP002933 |
| Business Practice Address: | 18901 Greenwell Springs Rd Greenwell Springs, LA - 707394836 |
| Business Phone Number: | 2259249985 |
| Business Fax Number: | |
| Mailing Address: | 31861 Netterville Rd, DENHAM SPRINGS |
| State: | LA |
| Postal Code: | 707261525 |
| Phone Number: | 2257888538 |
| Fax Number: | |
| NPI Enumeration Date: | 07/02/2012 |
| NPI Last Update Date: | 07/02/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LA2200X |
| License Number: | TAP002933 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | LA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Adult Health |
| Taxonomy Definition: | |