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Individual

PATRICIA MOORE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
1101 SAM PERRY BLVD STE 307, FREDERICKSBURG, VA 22401-4466
(540) 374-3277
(540) 374-3280
Mailing address
22 ACACIA CT, FREDERICKSBURG, VA 22405-2131
(540) 226-9935

Taxonomy

Speciality
Code
Description
License number
State
163WH1000X
Hospice Registered Nurse
0001137010
VA
363LA2200X
Adult Health Nurse Practitioner
0024174222
VA
363LG0600X
Gerontology Nurse Practitioner
Primary
0024174222
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1336699800
VA
Enumeration date
10/09/2016
Last updated
07/21/2022
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