Individual
MISS ADELE PETIGRU MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
F.N.P.
Contact information
Practice address
2145 HENRY TECKLENBURG DR STE 220, CHARLESTON, SC 29414-5894
(843) 723-8823
(843) 606-8059
Mailing address
PO BOX 751649, CHARLOTTE, NC 28275-1649
(843) 789-1620
(843) 724-2440
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
3716
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
NP2192
—
SC
Enumeration date
11/21/2008
Last updated
10/30/2020
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