Individual
MS. ALEXANDRA A MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
1008
NH
363AS0400X
Surgical Physician Assistant
1008
—
363AS0400X
Surgical Physician Assistant
PA5477
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1376969527
—
MA
01
—
PA5477
LICENSE
MA
Enumeration date
03/12/2014
Last updated
03/12/2020
Update your record
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