Provider Demographics
NPI:1841431277
Name:MOORE, KRISTY STRICKLAND (NP-C)
Entity Type:Individual
Prefix:MRS
First Name:KRISTY
Middle Name:STRICKLAND
Last Name:MOORE
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6130 PRESTLEY MILL RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:DOUGLASVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30134-2288
Mailing Address - Country:US
Mailing Address - Phone:770-771-5100
Mailing Address - Fax:404-446-1770
Practice Address - Street 1:6130 PRESTLEY MILL RD
Practice Address - Street 2:SUITE B
Practice Address - City:DOUGLASVILLE
Practice Address - State:GA
Practice Address - Zip Code:30134-2288
Practice Address - Country:US
Practice Address - Phone:770-771-5100
Practice Address - Fax:404-446-1770
Is Sole Proprietor?:No
Enumeration Date:2009-03-15
Last Update Date:2009-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN167524363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily