Individual
BRAD E MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
301 MED TECH PKWY STE 240, JOHNSON CITY, TN 37604-2641
(423) 794-5520
(423) 282-6940
Mailing address
PO BOX 632476, CINCINNATI, OH 45263-2476
(423) 794-5520
(234) 283-9480
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
194218
TN
363LF0000X
Family Nurse Practitioner
Primary
22515
TN
Other
Enumeration date
03/24/2017
Last updated
03/03/2025
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