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NPI Code Detail

MEDICARE: MRS. DANA LEWIS MOORE FNP-C

MEDICARE: MRS. DANA LEWIS MOORE 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 PractitionerRN123301GA

General Provider Information

NPI Number : 1992107411
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. DANA LEWIS MOORE FNP-C
Provider Business Mailing Address
First Line : 1826 VETERANS BLVD
Second Line :
City : DUBLIN
State : GA
Zip : 31021-3631
Country : US
Telephone Number : 478-272-1210
Fax Number :
Provider Business Practice Location Address
First Line : 1826 VETERANS BLVD
Second Line :
City : DUBLIN
State : GA
Zip : 31021-3631
Country : US
Telephone Number : 478-272-1210
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/16/2014
Last Update Date : 12/07/2025

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