Provider Demographics
NPI:1477127330
Name:MOORE, RAMONA ANNETTE LOUSIE (DNP, FNP-C)
Entity Type:Individual
Prefix:DR
First Name:RAMONA
Middle Name:ANNETTE LOUSIE
Last Name:MOORE
Suffix:
Gender:F
Credentials:DNP, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:806 S COOPER ST
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38104-5406
Mailing Address - Country:US
Mailing Address - Phone:901-896-0739
Mailing Address - Fax:833-695-8358
Practice Address - Street 1:806 S COOPER ST
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38104-5406
Practice Address - Country:US
Practice Address - Phone:901-896-0739
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-16
Last Update Date:2022-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN27232363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily