Individual provider · Type 1 NPI
Mark Benton Moore, ARNP
Pediatric Nurse Practitioner · Charlotte, NC
NPI number
1205948981
Active
Practice location
1000 Blythe Blvd
Charlotte, NC 28203-5812
Fax (704) 355-6227
Mailing address
PO Box 601372
Charlotte, NC 28260-1372
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Pediatric Nurse Practitioner Primary | 363LP0200X | 9700154 (NC) |
| Nurse Practitioner | 363L00000X | 18527 (TN) |
| Pediatric Nurse Practitioner | 363LP0200X | ARNP 9219935 (FL) |
Pediatric Nurse Practitioner: Definition to come...
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About NPI 1205948981
Mark Benton Moore, ARNP's National Provider Identifier is 1205948981, issued on Aug 31, 2006. The primary taxonomy on file is Pediatric Nurse Practitioner (363LP0200X), and the practice location is in Charlotte, NC. The record was last updated on Dec 6, 2021.