Ashley Nicole Moore, FNP-C
Individual provider Active NPI Family Medicine Physician · Mansfiel, TX
NPI 1003698937 · NPPES record last updated Mar 6, 2024
Key facts
- NPI
- 1003698937
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 1129661 (TX)
- Practice address
- 2606 Wallingford Dr
Mansfiel, TX 76084-1156 - Phone
- (817) 733-7085
- NPI assigned
- Oct 16, 2023
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1129661 | TX | MD | Family Medicine Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 1129661 | TX | Yes |
Addresses
Primary practice location
2606 Wallingford Dr
Mansfiel, TX 76084-1156
Mailing address
2606 Wallingford Dr
Mansfiel, TX 76084-1156
Phone (817) 733-7085
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 6, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.