Individual
CECILIA PICKETT MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP
Contact information
Practice address
274 BIG A RD, TOCCOA, GA 30577-6002
(706) 886-8414
(706) 827-5083
Mailing address
PO BOX 742616, ATLANTA, GA 30374-2616
(770) 219-8420
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
RN134600
GA
363LP0200X
Pediatric Nurse Practitioner
RN134600
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000891767M
—
GA
Enumeration date
07/20/2006
Last updated
11/12/2021
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