MEDICARE: SABRINA 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	363L00000X	Nurse Practitioner	5018906	NC
2	163W00000X	Registered Nurse	302141	NC

General Provider Information

NPI Number	:	1952041311
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SABRINA MOORE

Provider Business Mailing Address
First Line	:	PO BOX 60447
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28260-0447
Country	:	US
Telephone Number	:	980-302-6761
Fax Number	:

Provider Business Practice Location Address
First Line	:	14135 BALLANTYNE CORPORATE PL STE 200
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28277-0768
Country	:	US
Telephone Number	:	980-488-9520
Fax Number	:

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

Provider Enumeration Date	:	03/31/2022
Last Update Date	:	12/16/2025

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Directions to “ SABRINA MOORE ” Practice Location

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