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Individual

MS. DONNA A MOORE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
APRN-C, PMHNP-BC, MS

Contact information

Practice address
915 INTERSTATE RIDGE DR, GAINESVILLE, GA 30501-7076
(516) 493-2203
Mailing address
599 MADISON PARK DR, GRAYSON, GA 30017-7940
(516) 493-2203

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
5796691
NY
363LA2200X
Adult Health Nurse Practitioner
95029693
CA
363LA2200X
Adult Health Nurse Practitioner
RN241756
GA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
RN241756
GA
363LP2300X
Primary Care Nurse Practitioner
11034073
FL

Other

Enumeration date
12/26/2007
Last updated
03/12/2025
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