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General NPI Number Information
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NPI Number | 1871001412
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Entity Type | Individual
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Provider Name | EMILY DAWN MOORE CRNP
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Gender | Female
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Dates
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Enumeration Date | 01/17/2018
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Last Update Date | 01/17/2018
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Provider Practice Location Address
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Address Line | 1215 7TH ST SE
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City | DECATUR
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State | AL
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Zip | 35601-3304
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Country | US
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Telephone | 256-973-4885
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Fax | 256-973-4805
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Provider Business Mailing Address
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Address Line | 1401 BYRD RD SE
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City | HARTSELLE
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State | AL
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Zip | 35640-5940
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Country | US
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Telephone | 256-566-4097
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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 | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 1-123706
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License Number State | AL
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