Individual
AMY MOON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
237 N FAYETTEVILLE ST STE D, ASHEBORO, NC 27203-5573
(336) 625-2961
(336) 625-6573
Mailing address
218 FOUST ST, STE C, ASHEBORO, NC 27203-5476
(336) 625-2333
(336) 625-5511
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
600124
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7005252
—
NC
Enumeration date
10/04/2006
Last updated
12/01/2016
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