Individual
WENDY B MOOSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
90 SOUTHSIDE AVE, SUITE 350, ASHEVILLE, NC 28801-4160
(828) 277-4810
Mailing address
90 SOUTHSIDE AVE, SUITE 350, ASHEVILLE, NC 28801-4160
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
5007149
NC
363LA2200X
Adult Health Nurse Practitioner
5007149
NC
363LG0600X
Gerontology Nurse Practitioner
Primary
5007149
NC
363LP2300X
Primary Care Nurse Practitioner
5007149
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1386044501
—
NC
01
—
1897C
BCBS NC
NC
Enumeration date
08/25/2014
Last updated
12/08/2016
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