Individual
ANGELA W MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2411 S NC HIGHWAY 11, ROSE HILL, NC 28458-8467
(910) 289-7678
Mailing address
2750 WILLARD RD, WILLARD, NC 28478-6472
(910) 289-7678
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
311ZA0620X
—
NC
Enumeration date
05/21/2022
Last updated
05/21/2022
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