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:
Health care specialties
Specialty | Code | License # | 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 last year |
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 | 1447223706 | NPPES |
South Carolina | MEDICAID | NP0928 |
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