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NPI Code Detail

MEDICARE: MS. KRISTIN DELAGRANGE MOORE AUD

MEDICARE: MS. KRISTIN DELAGRANGE MOORE AUD
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
1231H00000XAudiologist4805NC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
29195272OTHERNCAETNA
31628VOTHERNCBCBSNC
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
530106724OTHERSCSELECT HEALTH OF SC
66798431OTHERNCCIGNA

General Provider Information

NPI Number : 1528230778
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. KRISTIN DELAGRANGE MOORE AUD
Provider Business Mailing Address
First Line : 1025 ANDUIN FALLS DR
Second Line :
City : CHARLOTTE
State : NC
Zip : 28269-7004
Country : US
Telephone Number : 980-343-5455
Fax Number : 980-343-2451
Provider Business Practice Location Address
First Line : 4421 STUART ANDREW BLVD
Second Line :
City : CHARLOTTE
State : NC
Zip : 28217-1589
Country : US
Telephone Number : 980-343-6960
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/27/2008
Last Update Date : 06/10/2026

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