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Individual

MELISSA R MOORE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
854 W JAMES CAMPBELL BLVD, SUITE 301, COLUMBIA, TN 38401-4659
(931) 388-8779
(931) 540-0518
Mailing address
854 W JAMES CAMPBELL BLVD, SUITE 303, COLUMBIA, TN 38401-4659
(931) 540-4255
(931) 540-4218

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
12886
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3341405
TN
05
3710089
TN
01
4168669
BCBST
TN
Enumeration date
10/15/2007
Last updated
03/10/2008
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