Provider Demographics
NPI:1386072296
Name:MOORE, DANNAH MICHELE (MSN, RN, PMHNP-BC)
Entity type:Individual
Prefix:
First Name:DANNAH
Middle Name:MICHELE
Last Name:MOORE
Suffix:
Gender:F
Credentials:MSN, RN, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:429 ROPER MOUNTAIN RD STE 901
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29615-4254
Mailing Address - Country:US
Mailing Address - Phone:864-664-3121
Mailing Address - Fax:864-860-7532
Practice Address - Street 1:429 ROPER MOUNTAIN RD STE 901
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29615-4254
Practice Address - Country:US
Practice Address - Phone:864-664-3121
Practice Address - Fax:864-860-7532
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-31
Last Update Date:2025-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC277632084P0800X
SC2204102084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry