Individual
DOMINIQUE MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
12300 WASHINGTON HWY, ASHLAND, VA 23005-7646
(804) 897-9355
Mailing address
12300 WASHINGTON HWY, ASHLAND, VA 23005-7646
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
0024188517
VA
Other
Enumeration date
10/20/2023
Last updated
01/12/2026
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