Provider Demographics
NPI:1649423880
Name:MOORS, BEVERLY (FNP-C)
Entity Type:Individual
Prefix:MS
First Name:BEVERLY
Middle Name:
Last Name:MOORS
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1735 CITY CENTER BLVD
Mailing Address - Street 2:
Mailing Address - City:ELIZABETH CITY
Mailing Address - State:NC
Mailing Address - Zip Code:27909-8960
Mailing Address - Country:US
Mailing Address - Phone:252-338-2155
Mailing Address - Fax:252-338-7704
Practice Address - Street 1:1735 CITY CENTER BLVD
Practice Address - Street 2:
Practice Address - City:ELIZABETH CITY
Practice Address - State:NC
Practice Address - Zip Code:27909-8960
Practice Address - Country:US
Practice Address - Phone:252-338-2155
Practice Address - Fax:252-338-7704
Is Sole Proprietor?:No
Enumeration Date:2008-10-31
Last Update Date:2013-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC228175363LF0000X, 364SP0200X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No364SP0200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPediatrics