Individual
COLEEN E MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
4600 OLEANDER DR, WILMINGTON, NC 28403-5149
(866) 389-2727
Mailing address
4600 OLEANDER DR, WILMINGTON, NC 28403-5149
Taxonomy
Speciality
Code
Description
License number
State
207QA0000X
Adolescent Medicine (Family Medicine) Physician
252661
NC
363LF0000X
Family Nurse Practitioner
Primary
252661
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7006308
—
NC
Enumeration date
07/31/2012
Last updated
04/01/2016
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