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NPI Code Detail

MEDICARE: MS. BEVERLY MOORS FNP-C

MEDICARE: MS. BEVERLY MOORS FNP-C
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
1363LF0000XFamily Nurse Practitioner228175NC
2364SP0200XPediatric Clinical Nurse Specialist228175NC
3363L00000XNurse Practitioner228175NC

General Provider Information

NPI Number : 1649423880
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. BEVERLY MOORS FNP-C
Provider Business Mailing Address
First Line : 1735 CITY CENTER BLVD
Second Line :
City : ELIZABETH CITY
State : NC
Zip : 27909-8960
Country : US
Telephone Number : 252-338-2155
Fax Number : 252-338-7704
Provider Business Practice Location Address
First Line : 1735 CITY CENTER BLVD
Second Line :
City : ELIZABETH CITY
State : NC
Zip : 27909-8960
Country : US
Telephone Number : 252-338-2155
Fax Number : 252-338-7704
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/31/2008
Last Update Date : 07/17/2013

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