Individual
MRS. PAMELA J MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP
Contact information
Practice address
1000 PINE STREET, VARNVILLE, SC 29944-0969
(803) 943-5228
(803) 943-4591
Mailing address
1000 PINE ST, VARNVILLE, SC 29944-0969
(803) 943-5228
(803) 943-4591
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
1881
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP0365
—
SC
05
—
RHC013
—
SC
Enumeration date
07/22/2005
Last updated
06/24/2010
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