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General NPI Number Information
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NPI Number | 1184062556
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Entity Type | Individual
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Provider Name | SCOTT EMORY MOORE APRN-CNP, AGPCNP-BC
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Gender | Male
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Dates
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Enumeration Date | 06/07/2013
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Last Update Date | 03/26/2026
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Provider Practice Location Address
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Address Line | 4437 ROADOAN RD
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City | BROOKLYN
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State | OH
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Zip | 44144-2745
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Country | US
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Telephone | 864-430-5093
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Fax |
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Provider Business Mailing Address
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Address Line | 4437 ROADOAN RD
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City | BROOKLYN
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State | OH
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Zip | 44144-2745
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Country | US
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Telephone | 864-430-5093
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | APRN.CNP.0041841
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License Number State | OH
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