Individual
DR. ALEXANDER GRAY MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DNP, PMHNP-BC
Contact information
Practice address
1 MEDICAL PARK BLVD FL 5, BRISTOL, TN 37620-7430
(423) 844-6000
(423) 844-6027
Mailing address
105 W STONE DR STE 6A, KINGSPORT, TN 37660-3256
(423) 408-7220
(423) 408-7405
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
207815
TN
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
24675
TN
Other
Enumeration date
11/01/2018
Last updated
11/01/2018
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