Provider Demographics
NPI:1477571727
Name:MOORE, TERRY M (FNP)
Entity Type:Individual
Prefix:
First Name:TERRY
Middle Name:M
Last Name:MOORE
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:TERRY
Other - Middle Name:A
Other - Last Name:MCCAFFREY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP-BC
Mailing Address - Street 1:120 W WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27856-1378
Mailing Address - Country:US
Mailing Address - Phone:252-462-2632
Mailing Address - Fax:225-246-2268
Practice Address - Street 1:120 W WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:NC
Practice Address - Zip Code:27856-1378
Practice Address - Country:US
Practice Address - Phone:252-462-2632
Practice Address - Fax:225-246-2268
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2013-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCRN 074175163WP0809X
NC201002363LF0000X, 363LX0106X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult
No363LX0106XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerOccupational Health
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7004389Medicaid
NC2825524Medicare PIN
NCQ70725Medicare UPIN