Individual
JOLEEN COMER MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
211 BONNIE BROOK RD, ABERDEEN, NC 28315-3125
(910) 716-0099
(910) 405-1359
Mailing address
211 BONNIE BROOK RD, ABERDEEN, NC 28315-3125
(910) 716-0099
(910) 405-1359
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
22951
SC
363LF0000X
Family Nurse Practitioner
Primary
201093
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5422951
DHEC
SC
05
—
NP6037
—
SC
Enumeration date
11/15/2005
Last updated
03/07/2023
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