Provider Demographics
NPI:1306276803
Name:MOORE, ERIN ALYCIA (PA-C, MSPAS)
Entity type:Individual
Prefix:MRS
First Name:ERIN
Middle Name:ALYCIA
Last Name:MOORE
Suffix:
Gender:F
Credentials:PA-C, MSPAS
Other - Prefix:MISS
Other - First Name:ERIN
Other - Middle Name:ALYCIA
Other - Last Name:EGGERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C, MSPAS
Mailing Address - Street 1:20 MEDICAL PARK DR
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28803-2493
Mailing Address - Country:US
Mailing Address - Phone:828-253-7077
Mailing Address - Fax:
Practice Address - Street 1:800 N JUSTICE ST
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28791-3410
Practice Address - Country:US
Practice Address - Phone:828-694-4548
Practice Address - Fax:828-694-4547
Is Sole Proprietor?:No
Enumeration Date:2013-11-19
Last Update Date:2021-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0010-04573363A00000X, 363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCNCW544AOtherMEDICARE PTAN
NCP01817146OtherRR MEDICARE
NCNCW544CMedicare PIN
NCNCW544BMedicare PIN