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MRS. AMANDA MICHELE MOORE NP-C NPI 1063769719

NPI Profile

NPI: 1063769719

Provider Name: MRS. AMANDA MICHELE MOORE, NP-C

Classification: Nurse Practitioner - 363LF0000X

Entity Type: Individual

Specialization: Family

Organization: SAMINA YOUSUF MD PC

PECOS Registration: Yes

Address:
142 HIGHLAND DR
LEBANON, VA
ZIP 24266

Phone: (276) 889-0433

MRS. Amanda Michele Moore, NP-C is a family nurse practitioner in Lebanon, VA with 3 years of experience. MRS. Amanda Michele Moore, NP-C NPI is 1063769719. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

Education
Medical School: UNIVERSITY OF VIRGINIA SCHOOL OF MEDICINE
Graduation Year:2012

The provider's business location address is:

142 HIGHLAND DR
LEBANON, VA
ZIP 24266-636
Phone: (276) 889-0433
Fax: (276) 889-5537

The NPI 1063769719 is registered in the Medicare Provider, Enrollment, Chain and Ownership System PECOS.

The enumeration date for this NPI number is 8/13/2012 and was last updated on 5/13/2013.

Map - Location of Practice

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1 363LF0000X Nurse Practitioner Family 0024170245 VIRGINIA Yes

What is NPI?
NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 8/11/2015