Individual
KENDRA LARISSA MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
189 HOSPITAL DR, SPRUCE PINE, NC 28777-3035
(828) 766-3555
Mailing address
PO BOX 602373, CHARLOTTE, NC 28260-2373
(828) 213-1500
(828) 651-6570
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
5008316
NC
363LW0102X
Women's Health Nurse Practitioner
5008316
NC
Other
Enumeration date
01/28/2016
Last updated
01/04/2022
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