Individual
ALLISON D MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
1901 MELBA DRIVE, DOTHAN, AL 36301
(334) 794-6611
(334) 794-6614
Mailing address
1901 MELBA DRIVE, DOTHAN, AL 36301
(334) 794-6611
(334) 794-6614
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
1081292
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00012172
—
AL
01
—
051512172
BLUE CROSS BLUE SHIELD
AL
Enumeration date
03/18/2006
Last updated
11/19/2007
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