Healthcare Provider Details

I. General information

NPI: 1396837506
Provider Name (Legal Business Name): TERA DAWN CRITCHFIELD MOORE PHARM.D., BCACP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/28/2006
Last Update Date: 03/10/2023
Certification Date: 03/10/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

810 VERMONT AVE NW
WASHINGTON DC
20420-0001
US

IV. Provider business mailing address

6652 S BILOXI WAY
AURORA CO
80016-4464
US

V. Phone/Fax

Practice location:
  • Phone: 303-842-4853
  • Fax:
Mailing address:
  • Phone: 303-842-4853
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P2201X
TaxonomyAmbulatory Care Pharmacist
License Number41860
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: