Healthcare Provider Details

I. General information

NPI: 1407780075
Provider Name (Legal Business Name): ASHLEY KATHYRN MOORE DNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/10/2026
Last Update Date: 06/10/2026
Certification Date: 06/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4770 WILLOWSTONE DR
HIGH POINT NC
27265-9739
US

IV. Provider business mailing address

4770 WILLOWSTONE DR
HIGH POINT NC
27265-9739
US

V. Phone/Fax

Practice location:
  • Phone: 336-314-2977
  • Fax:
Mailing address:
  • Phone: 336-314-2977
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number307560
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: