Individual
JOHN WAYNE MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNP
Contact information
Practice address
136 COMMERCE AVE, VALLEY HEAD, AL 35989-2421
(256) 674-1052
(256) 674-1054
Mailing address
136 COMMERCE AVE, VALLEY HEAD, AL 35989-2421
(256) 674-1052
(256) 674-1054
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
1-087639
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1-087639
LICENSE
AL
Enumeration date
04/04/2013
Last updated
04/21/2023
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