Individual
DR. LISA ANNE JACKSON-MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
101 MANNING DR, CHAPEL HILL, NC 27514-4220
(919) 843-7850
(919) 966-6001
Mailing address
3031 OLD CLINIC BLDG, CB#7570, CHAPEL HILL, NC 27599-7570
(919) 843-8750
(919) 966-6001
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
97-00992
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
891120R
—
NC
Enumeration date
09/27/2005
Last updated
04/02/2021
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