Individual provider · Type 1 NPI

Brad Edward Moore, NP

Family Nurse Practitioner · Johnson City, TN

NPI number 1578094207 Active

Practice location

301 Med Tech Pkwy Ste 240
Johnson City, TN 37604-2641

Fax (423) 282-6940

Mailing address

PO Box 632476
Cincinnati, OH 45263-2476

Specialties and licenses

TaxonomyCodeLicense
Registered Nurse 163W00000X194218 (TN)
Family Nurse Practitioner Primary 363LF0000X22515 (TN)

Family Nurse Practitioner: Definition to come...

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About NPI 1578094207

Brad Edward Moore, NP's National Provider Identifier is 1578094207, issued on Mar 24, 2017. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Johnson City, TN. The record was last updated on May 20, 2026.