Healthcare Provider Details

I. General information

NPI: 1316021926
Provider Name (Legal Business Name): DEBBIE MOORE APRN-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/24/2006
Last Update Date: 02/25/2021
Certification Date: 02/25/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1504 WILLIAMS DR
MURFREESBORO TN
37129-3274
US

IV. Provider business mailing address

115 N THOMPSON LN
MURFREESBORO TN
37129-4305
US

V. Phone/Fax

Practice location:
  • Phone: 615-278-2241
  • Fax: 615-206-7587
Mailing address:
  • Phone: 615-896-4482
  • Fax: 615-896-4472

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPN0000007533
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: