Jackson-Moore, Lisa Anne

Jackson-Moore, Lisa Anne is an individual health care provider with primary practice located at 101 Manning Dr , Chapel Hill NC 27514-4220. She recently has only one registered license in Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, which is considered as her primary health care specialty. Jackson-Moore, Lisa Anne can be contacted via phone (919) 843-7850.

Contact Information

Primary practice address
101 Manning Dr Chapel Hill NC 27514-4220
Phone: (919) 843-7850
Fax: (919) 966-6001
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X 97-00992 North Carolina

Profile Details

NPI number 1104812932
LBN Legal business name Jackson-Moore, Lisa Anne
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 27th, 2005
Last updated Apr 2nd, 2021 - 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1104812932 NPPES
North Carolina MEDICAID 891120R

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