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General NPI Number Information
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NPI Number | 1801503404
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Entity Type | Individual
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Provider Name | NICOLE ALEXANDRA MOORE APRN
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Gender | Female
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Dates
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Enumeration Date | 11/02/2022
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Last Update Date | 08/12/2024
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Provider Practice Location Address
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Address Line | 246 PLEASANT ST BLDG WEST2ND
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City | CONCORD
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State | NH
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Zip | 03301-2548
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Country | US
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Telephone | 603-224-4003
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Fax | 603-227-7526
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Provider Business Mailing Address
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Address Line | 250 PLEASANT ST
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City | CONCORD
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State | NH
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Zip | 03301-2598
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Country | US
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Telephone | 603-227-7000
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Fax | 603-227-7827
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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 | 077761-21
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License Number State | NH
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Taxonomy #2
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | 077761-23
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License Number State | NH
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