Individual
BECKY MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3100 BLUE RIDGE RD, #103, RALEIGH, NC 27612-8036
(919) 719-2250
Mailing address
3100 BLUE RIDGE RD, #103, RALEIGH, NC 27612-8036
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
0010-06237
NC
363A00000X
Physician Assistant
Primary
PA00548
MS
Other
Enumeration date
04/01/2016
Last updated
03/27/2026
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