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NPI Code Detail

MEDICARE: MRS. CHERYL STEWART MOORE CRNA

MEDICARE: MRS. CHERYL STEWART MOORE CRNA
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
1367500000XCertified Registered Nurse Anesthetist45272NC

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1P00117358OTHERNCRR MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1760414924
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. CHERYL STEWART MOORE CRNA
Provider Business Mailing Address
First Line : 265 N 3RD ST
Second Line :
City : ALBEMARLE
State : NC
Zip : 28001-4011
Country : US
Telephone Number : 704-985-0144
Fax Number :
Provider Business Practice Location Address
First Line : 612 MOCKSVILLE AVE
Second Line :
City : SALISBURY
State : NC
Zip : 28144-2732
Country : US
Telephone Number : 704-210-5661
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/07/2006
Last Update Date : 11/05/2024

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