Provider Demographics
NPI:1518551019
Name:MOORE, CASSANDRA DAWN (MSN, APRN, NNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:CASSANDRA
Middle Name:DAWN
Last Name:MOORE
Suffix:
Gender:F
Credentials:MSN, APRN, NNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4104 S MERIDIAN GREENS DR
Mailing Address - Street 2:
Mailing Address - City:DICKINSON
Mailing Address - State:TX
Mailing Address - Zip Code:77539-8393
Mailing Address - Country:US
Mailing Address - Phone:409-392-3074
Mailing Address - Fax:
Practice Address - Street 1:2424 ERWIN ROAD, HOCK PLAZA
Practice Address - Street 2:SUITE #504
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27705
Practice Address - Country:US
Practice Address - Phone:919-681-5551
Practice Address - Fax:919-681-6065
Is Sole Proprietor?:No
Enumeration Date:2021-02-24
Last Update Date:2021-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5014114363LN0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0005XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal, Critical Care