Moore, Marla J

Moore, Marla J is an individual health care provider with primary practice located at 457 Vista Dr , Sparta TN 38583. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as her primary health care specialty. Moore, Marla J can be contacted via phone (931) 738-3383.

Contact Information

Primary practice address
457 Vista Dr Sparta TN 38583
Phone: (931) 738-3383
Fax: (931) 738-8911
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X RN0000077820 Tennessee

Profile Details

NPI number 1740279397
LBN Legal business name Moore, Marla J
Credentials Family Nurse Practitioner (FNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 17th, 2005
Last updated Nov 23rd, 2009 - about 15 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 1740279397 NPPES
Tennessee MEDICAID 3342626

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