NASTASSJA R MOORE N.P. NPI 1841639762

NPI Information

NPI: 1841639762
Provider Name: NASTASSJA R MOORE, N.P.
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

PECOS Registration: Yes

Address:
2341 MCCALLIE AVE STE 403
CHATTANOOGA, TN
ZIP 37404
Phone: (423) 602-9674
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Nastassja R Moore, N.P. is a family nurse practitioner in Chattanooga, TN. Nastassja R Moore, N.P. NPI is 1841639762. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

2341 MCCALLIE AVE STE 403
CHATTANOOGA, TN
ZIP 37404
Phone: (423) 602-9674
Fax: (423) 602-9690

The NPI 1841639762 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 6/25/2013 and was last updated on 6/7/2018.

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	163W00000X	Registered Nurse		161491	TENNESSEE	No
2	363LF0000X	Nurse Practitioner	Family	17742	TENNESSEE	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	Q000920	MEDICAID	TENNESSEE
2	003136096A	MEDICAID	GEORGIA

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: 4/28/2024

NPI Synchronization or Removal

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