MEDICARE: KAYLA MCKENZIE 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
1	163W00000X	Registered Nurse	369416	NC

General Provider Information

NPI Number	:	1487508271
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAYLA MCKENZIE MOORE

Provider Business Mailing Address
First Line	:	160 SHADY LN
Second Line	:
City	:	ADVANCE
State	:	NC
Zip	:	27006-6660
Country	:	US
Telephone Number	:	336-408-8403
Fax Number	:

Provider Business Practice Location Address
First Line	:	1 MEDICAL CENTER BLVD
Second Line	:
City	:	WINSTON SALEM
State	:	NC
Zip	:	27157-0001
Country	:	US
Telephone Number	:	336-408-8403
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/26/2026
Last Update Date	:	02/26/2026

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Directions to “ KAYLA MCKENZIE MOORE ” Practice Location

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