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NPI Code Detail

MEDICARE: RHONDA MOORE AGPCNP-BC

MEDICARE: RHONDA MOORE AGPCNP-BC
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
1363LG0600XGerontology Nurse PractitionerR871925MS

General Provider Information

NPI Number : 1669914826
Entity Type Code : Individual
Provider Name (Legal Business Name) : RHONDA MOORE AGPCNP-BC
Provider Business Mailing Address
First Line : 24345 HIGHWAY 15
Second Line :
City : UNION
State : MS
Zip : 39365-8575
Country : US
Telephone Number : 601-747-8211
Fax Number : 601-774-8321
Provider Business Practice Location Address
First Line : 24345 HIGHWAY 15
Second Line :
City : UNION
State : MS
Zip : 39365-8575
Country : US
Telephone Number : 601-774-8211
Fax Number : 601-774-8589
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/04/2016
Last Update Date : 06/10/2024

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Directions to “ RHONDA MOORE AGPCNP-BC” Practice Location

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