Moore, Jacqueline G

Moore, Jacqueline G is an individual health care provider with primary practice located at 171 Ashley Ave , Charleston SC 29425-8908. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, Physician Assistants & Advanced Practice Nursing Providers / Women's Health. Physician Assistants & Advanced Practice Nursing Providers / Women's Health is her primary health care specialty. Moore, Jacqueline G can be contacted via phone (843) 792-1414.

Contact Information

Primary practice address
171 Ashley Ave Charleston SC 29425-8908
Phone: (843) 792-1414
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X APN2363 South Carolina
Physician Assistants & Advanced Practice Nursing Providers / Women's Health 363LW0102X 2363 South Carolina

Profile Details

NPI number 1447223706
LBN Legal business name Moore, Jacqueline G
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 8th, 2006
Last updated Apr 3rd, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1447223706 NPPES
South Carolina MEDICAID NP0928

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