Healthcare Provider Details

I. General information

NPI: 1649508698
Provider Name (Legal Business Name): VIRGINIA ANNA SUE MOORE MSN, WHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/03/2009
Last Update Date: 12/03/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

412 DR. D.B. TODD, JR. BLVD PLANNED PARENTHOOD OF MIDDLE TENNESSEE
NASHVILLE TN
37203
US

IV. Provider business mailing address

2801 W. LINDEN AVE
NASHVILLE TN
37212-4710
US

V. Phone/Fax

Practice location:
  • Phone: 615-321-7216
  • Fax: 615-320-5233
Mailing address:
  • Phone: 615-386-9558
  • Fax: 615-460-0037

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberAPN0000005504
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: