Individual
VICKIE B MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2728 OLD FOREST ROAD, LYNCHBURG, VA 24501-2435
(434) 385-7818
(434) 385-7820
Mailing address
2728 OLD FOREST ROAD, LYNCHBURG, VA 24501-2435
(434) 385-7818
(434) 385-7820
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
0024059060
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
007780125
—
VA
Enumeration date
11/18/2005
Last updated
12/20/2011
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