Individual
BA'SHARRA ANEKA MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
890 2ND ST STE 201, MACON, GA 31201-6863
(478) 745-4322
(478) 254-3629
Mailing address
890 2ND ST STE 201, MACON, GA 31201-6863
(478) 745-4322
(478) 254-3629
Taxonomy
Speciality
Code
Description
License number
State
163WN0300X
Nephrology Registered Nurse
RN252151
GA
363LA2200X
Adult Health Nurse Practitioner
Primary
RN252151
GA
Other
Enumeration date
10/06/2022
Last updated
03/03/2023
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