Individual
TERRICA MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP, CPNP-PC
Contact information
Practice address
3674 GOODMAN RD E, SOUTHAVEN, MS 38672-6402
(662) 890-7747
Mailing address
6919 LAGRANGE PINES RD, CORDOVA, TN 38018-2857
(901) 596-6657
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
202019164
TN
Other
Enumeration date
04/19/2021
Last updated
04/19/2021
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