Individual
LISA MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
748 ADDINGTON DR, WINTERVILLE, NC 28590-7102
(252) 481-7122
Mailing address
748 ADDINGTON DR, WINTERVILLE, NC 28590-7102
(252) 414-3318
(252) 677-6551
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
208959
NC
363L00000X
Nurse Practitioner
Primary
5007549
NC
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
0024193436
VA
Other
Enumeration date
03/26/2015
Last updated
12/16/2025
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