Healthcare Provider Details

I. General information

NPI: 1619444544
Provider Name (Legal Business Name): ALYSIA NICOLE MOORE APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/29/2018
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

SC HOUSE CALLS, INC 111 DOCTORS CIR
COLUMBIA SC
29203
US

IV. Provider business mailing address

SC HOUSE CALLS, INC 111 DOCTORS CIR
COLUMBIA SC
29203
US

V. Phone/Fax

Practice location:
  • Phone: 800-491-0909
  • Fax: 803-329-2184
Mailing address:
  • Phone: 800-491-0909
  • Fax: 803-329-2184

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number22354
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number22354
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: