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General NPI Number Information
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NPI Number | 1568438547
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Entity Type | Individual
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Provider Name | EARNEST DARREN MOORE CRNA
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Gender | Male
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Dates
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Enumeration Date | 02/28/2006
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Last Update Date | 12/10/2025
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Provider Practice Location Address
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Address Line | 619 S 8TH ST STE 302
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City | GRIFFIN
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State | GA
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Zip | 30224-4260
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Country | US
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Telephone | 888-408-0200
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Fax | 888-505-6721
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Provider Business Mailing Address
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Address Line | 7288 SNAPDRAGON LN
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City | OOLTEWAH
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State | TN
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Zip | 37363-6579
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Country | US
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Telephone | 423-304-0247
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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 | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | RN136019
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | APN11360
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License Number State | TN
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Taxonomy #3
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | RN108827
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License Number State | GA
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