Individual
SAMANTHA NICOLE MOYER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BSN, RN, MHS, PA-C
Contact information
Practice address
3009 NEW BERN AVE, RALEIGH, NC 27610-1214
(919) 232-5020
Mailing address
PO BOX 603949, CHARLOTTE, NC 28260-3949
(919) 350-0351
(919) 350-7687
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
289332
NC
363A00000X
Physician Assistant
0010-12589
NC
363AS0400X
Surgical Physician Assistant
Primary
0010-12589
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1922731900
—
NC
Enumeration date
07/06/2022
Last updated
10/10/2023
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