Moore, Jennifer Marie
Moore, Jennifer Marie is an individual health care provider with primary practice located at 1110 Kildaire Farm Rd , Cary NC 27511-4523. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Moore, Jennifer Marie can be contacted via phone (919) 481-0277.Contact Information
Primary practice address
1110 Kildaire Farm Rd
Cary NC 27511-4523
Phone: (919) 481-0277
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | 010268-1 | New York |
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | 001002915 | North Carolina |
Profile Details
| NPI number | 1588623367 |
|---|---|
| LBN Legal business name | Moore, Jennifer Marie |
| Credentials | Physician Assistant (PA) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 21st, 2006 |
| Last updated | Aug 26th, 2022 - about 4 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1588623367 | NPPES |
| New York | MEDICAID | 02670611 | |
| New York | Other | P00204701 | |
| New York | Other | CC8362 |
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