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General NPI Number Information
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NPI Number | 1396184222
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Entity Type | Individual
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Provider Name | AMBER MICHELLE MOORE FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 06/25/2013
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Last Update Date | 02/13/2017
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Provider Practice Location Address
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Address Line | 320 8TH ST
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City | NEWPORT
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State | TN
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Zip | 37821-3902
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Country | US
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Telephone | 423-623-4893
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Fax |
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Provider Business Mailing Address
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Address Line | 6350 W ANDREW JOHNSON HWY DEPARTMENT 100
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City | TALBOTT
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State | TN
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Zip | 37877-8605
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Country | US
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Telephone |
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN132656
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APN17668
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License Number State | TN
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