Individual
CAROLINE FOUNTAIN MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
15441 US HIGHWAY 17 STE 501, HAMPSTEAD, NC 28443-0016
(910) 685-7307
Mailing address
133 PARKSIDE LN, HOLLY RIDGE, NC 28445-8836
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0010-14625
NC
Other
Enumeration date
03/29/2024
Last updated
10/09/2024
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