Provider Demographics
NPI:1528216405
Name:MOORE, ALVASHTIA P (APRN)
Entity Type:Individual
Prefix:MS
First Name:ALVASHTIA
Middle Name:P
Last Name:MOORE
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 INTERNATIONAL PLZ STE 602
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37217-2028
Mailing Address - Country:US
Mailing Address - Phone:615-367-8787
Mailing Address - Fax:
Practice Address - Street 1:2 INTERNATIONAL PLZ STE 602
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37217-2028
Practice Address - Country:US
Practice Address - Phone:615-367-8787
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-03
Last Update Date:2021-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNRN00000128007363LA2200X
TN8078363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health