Individual
CHERYL MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
650 NEW YORK ST, MEMPHIS, TN 38104-5536
(901) 728-5858
Mailing address
650 NEW YORK ST, MEMPHIS, TN 38104-5536
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
89816
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3641284
—
TN
01
—
4120637
BCBS OF TN
TN
05
—
78014586
—
KY
Enumeration date
06/16/2006
Last updated
01/31/2023
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