Healthcare Provider Details

I. General information

NPI: 1477571727
Provider Name (Legal Business Name): TERRY M MOORE FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: TERRY A MCCAFFREY FNP-BC

II. Dates (important events)

Enumeration Date: 07/17/2006
Last Update Date: 02/04/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 W WASHINGTON ST
NASHVILLE NC
27856-1378
US

IV. Provider business mailing address

120 W WASHINGTON ST
NASHVILLE NC
27856-1378
US

V. Phone/Fax

Practice location:
  • Phone: 252-462-2632
  • Fax: 225-246-2268
Mailing address:
  • Phone: 252-462-2632
  • Fax: 225-246-2268

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License NumberRN 074175
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number201002
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code363LX0106X
TaxonomyOccupational Health Nurse Practitioner
License Number201002
License Number StateNC
# 4
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number201002
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: