Individual provider · Type 1 NPI

Dominique Moore, NP

Psychiatric/Mental Health Nurse Practitioner · Ashland, VA

NPI number 1063294205 Active · reactivated Dec 17, 2025

Practice location

12300 Washington Hwy
Ashland, VA 23005-7646

Specialties and licenses

TaxonomyCodeLicense
Psychiatric/Mental Health Nurse Practitioner Primary 363LP0808X0024188517 (VA)

Psychiatric/Mental Health Nurse Practitioner: Definition to come...

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About NPI 1063294205

Dominique Moore, NP's National Provider Identifier is 1063294205, issued on Oct 20, 2023. The primary taxonomy on file is Psychiatric/Mental Health Nurse Practitioner (363LP0808X), and the practice location is in Ashland, VA. The record was last updated on Jan 12, 2026.