Provider Demographics
NPI:1275909269
Name:MOORE, ABBY (PA)
Entity Type:Individual
Prefix:
First Name:ABBY
Middle Name:
Last Name:MOORE
Suffix:
Gender:F
Credentials:PA
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Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:9295 SCENIC HWY
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32514-8055
Mailing Address - Country:US
Mailing Address - Phone:850-983-3528
Mailing Address - Fax:850-983-3546
Practice Address - Street 1:9295 SCENIC HWY
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32514-8055
Practice Address - Country:US
Practice Address - Phone:850-983-3528
Practice Address - Fax:850-983-3546
Is Sole Proprietor?:No
Enumeration Date:2015-08-13
Last Update Date:2022-04-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLPAT9108867363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant