| Phyllis P Moore, DNP,FNP-BC | |
|
600 Main St, Friendship, TN 38034-1999 | |
| (731) 677-3400 | |
| (731) 677-3402 |
| Full Name | Phyllis P Moore |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner |
| Experience | 15 Years |
| Location | 600 Main St, Friendship, Tennessee |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023374279 | NPI | - | NPPES |
| Q021117 | Medicaid | TN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363LF0000X | Nurse Practitioner - Family | APN0000016606 (Tennessee) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Fast Pace Medical Clinic Pllc | 5395881841 | 737 |
| Entity Name | University of Tennessee |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1780686436 PECOS PAC ID: 3072421213 Enrollment ID: O20031119000671 |
| Entity Name | Fast Pace Medical Clinic PLLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1134452865 PECOS PAC ID: 5395881841 Enrollment ID: O20091014000112 |
| Entity Name | Upperline Healthcare PC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1538686498 PECOS PAC ID: 4385900653 Enrollment ID: O20171114002720 |
| Mailing Address | Practice Location Address |
|---|---|
| Phyllis P Moore, DNP,FNP-BC 600 Main St, Friendship, TN 38034-1999 Ph: (731) 677-3400 | Phyllis P Moore, DNP,FNP-BC 600 Main St, Friendship, TN 38034-1999 Ph: (731) 677-3400 |
Madelyne Ellis, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1159 Walter Taylor Rd, Friendship, TN 38034 Phone: 931-787-4062 |
Ashley Blalock, Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 4903 Bruceville Slab Rd, Friendship, TN 38034 Phone: 731-676-0393 |