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General NPI Number Information
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NPI Number | 1780503490
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Entity Type | Individual
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Provider Name | NATISHA MONIQUE MOORE PSY.D, M.D.
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Gender | Female
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Dates
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Enumeration Date | 07/15/2026
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Last Update Date | 07/15/2026
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Provider Practice Location Address
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Address Line | PO BOX 443 278 MATTOOKS ROAD
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City | MAYSVILLE
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State | NC
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Zip | 28555
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Country | US
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Telephone | 910-358-8564
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 443
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City | MAYSVILLE
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State | NC
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Zip | 28555
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Country | US
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Telephone | 910-358-8564
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 420764
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 944592654T
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License Number State | AL
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