Individual provider · Type 1 NPI

Theresa Lynn Moore, PMHNP-BC

Psychiatric/Mental Health Nurse Practitioner · Winston Salem, NC

NPI number 1316561202 Active

Practice location

1615 Polo Rd
Winston Salem, NC 27106-3831

Fax (336) 201-0538

Other practice locations

  • 104 Cambridge Plaza Dr, Winston Salem, NC 27104-3556 · (336) 722-7266

Specialties and licenses

TaxonomyCodeLicense
Psychiatric/Mental Health Nurse Practitioner Primary 363LP0808X5022767 (NC)
Psychiatric/Mental Health Nurse Practitioner 363LP0808XNP95019703 (CA)

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

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About NPI 1316561202

Theresa Lynn Moore, PMHNP-BC's National Provider Identifier is 1316561202, issued on Jun 5, 2020. The primary taxonomy on file is Psychiatric/Mental Health Nurse Practitioner (363LP0808X), and the practice location is in Winston Salem, NC. The record was last updated on Jan 15, 2026.