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General NPI Number Information
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NPI Number | 1508615931
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Entity Type | Individual
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Provider Name | BRIANNA NICOLE MOORE WHNP-BC
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Gender | Female
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Dates
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Enumeration Date | 05/17/2024
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Last Update Date | 02/12/2025
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Provider Practice Location Address
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Address Line | 817 FEDERAL ST
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City | CAMDEN
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State | NJ
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Zip | 08103-1539
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Country | US
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Telephone | 856-583-2400
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Fax |
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Provider Business Mailing Address
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Address Line | 1540 S CHESTNUT ST
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City | PAULSBORO
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State | NJ
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Zip | 08066-1405
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Country | US
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Telephone | 856-472-6634
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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 | RN713189
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 26NR26663600
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License Number State | NJ
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Taxonomy #3
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Taxonomy Code | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number | SP028898
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License Number State | PA
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Taxonomy #4
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Taxonomy Code | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number | 26NJ15261100
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License Number State | NJ
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