Individual
CHADD JASON MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
100 HOSPITAL DR, HENDERSONVILLE, NC 28792-5272
(828) 681-2420
(828) 687-0729
Mailing address
PO BOX 1869, FLETCHER, NC 28732-1869
(828) 687-5616
(828) 650-8076
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
11099
TN
367500000X
Certified Registered Nurse Anesthetist
70304
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10069833
AMERIGROUP
TN
01
—
181WM
BCBS NC
NC
05
—
3629899
—
TN
01
—
4081901
BCBS
TN
01
—
74010612
KY MEDICAID
KY
01
—
P00162074
RAILROAD MEDICARE
TN
01
—
P01263433
MEDICARE RR
NC
Enumeration date
06/15/2006
Last updated
04/04/2017
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