Individual
EDWARD RYAN MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN, CRNP
Contact information
Practice address
454 TAYLOR RD, MONTGOMERY, AL 36117-3563
(334) 613-9000
(334) 532-0056
Mailing address
454 SADDLEWOOD DR, PIKE ROAD, AL 36064-2736
(334) 315-4813
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
1-163024
AL
363LF0000X
Family Nurse Practitioner
Primary
1-163024
AL
Other
Enumeration date
01/26/2021
Last updated
10/28/2021
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