Individual
MRS. AUDRA ELIZABETH MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
6131 S NORCROSS TUCKER RD STE 6, NORCROSS, GA 30093-5536
(678) 205-1959
Mailing address
1956 NORTHSIDE DR NW, ATLANTA, GA 30318-2631
(256) 777-0000
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
1-122815
AL
363LF0000X
Family Nurse Practitioner
Primary
RN266940
GA
Other
Enumeration date
06/21/2015
Last updated
02/21/2019
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