Provider Demographics
NPI:1821705575
Name:MOORE, CHRISTY L (NP)
Entity Type:Individual
Prefix:
First Name:CHRISTY
Middle Name:L
Last Name:MOORE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:106 FERRELL AVE STE 5
Mailing Address - Street 2:
Mailing Address - City:KINGSPORT
Mailing Address - State:TN
Mailing Address - Zip Code:37663-2371
Mailing Address - Country:US
Mailing Address - Phone:423-239-0099
Mailing Address - Fax:423-239-0273
Practice Address - Street 1:106 FERRELL AVE STE 5
Practice Address - Street 2:
Practice Address - City:KINGSPORT
Practice Address - State:TN
Practice Address - Zip Code:37663-2371
Practice Address - Country:US
Practice Address - Phone:423-239-0099
Practice Address - Fax:423-239-0273
Is Sole Proprietor?:No
Enumeration Date:2022-11-02
Last Update Date:2023-06-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TN32726363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily