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NPI Code Detail

MEDICARE: KATLYN NICOLE MOORE

MEDICARE: KATLYN NICOLE MOORE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LA2100XAcute Care Nurse PractitionerAPRN-NP281867GA

General Provider Information

NPI Number : 1083591176
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATLYN NICOLE MOORE
Provider Business Mailing Address
First Line : 2501 N PATTERSON ST
Second Line :
City : VALDOSTA
State : GA
Zip : 31602-1735
Country : US
Telephone Number : 229-433-1000
Fax Number :
Provider Business Practice Location Address
First Line : 2501 N PATTERSON ST
Second Line :
City : VALDOSTA
State : GA
Zip : 31602-1735
Country : US
Telephone Number : 229-433-1000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/19/2025
Last Update Date : 02/11/2026

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Directions to “ KATLYN NICOLE MOORE ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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