Individual
MRS. CARLA A ETHERTON MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
267 FOB JAMES DR, VALLEY, AL 36854-5077
(334) 710-0525
(334) 710-0574
Mailing address
PO BOX 1000, VALLEY, AL 36854-1000
(334) 710-0565
(334) 710-0574
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
1-093749
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
515-32708
BLUE CROSS OF AL PROV #
AL
05
—
891010840
—
AL
Enumeration date
04/24/2006
Last updated
03/30/2026
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