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Individual

CULLEN MOORE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
3000 NEW BERN AVE, RALEIGH, NC 27610-1231
(919) 350-8000
Mailing address
401 ALLISTER DR UNIT 108, RALEIGH, NC 27609-7272

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
273120
NC
367500000X
Certified Registered Nurse Anesthetist
0024188309
VA
367500000X
Certified Registered Nurse Anesthetist
Primary
006978
NC

Other

Enumeration date
03/08/2020
Last updated
12/14/2023
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