Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Andrea Moore, FNP-BC

Individual provider Family Nurse Practitioner · NPI 1336742410

Andrea Moore, FNP-BC is a Nurse Practitioner in Jackson, Mississippi. Qualified in 2016, 10 years ago. Practices with St Dominic Jackson Memorial, a 55-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Mississippi.

Years since qualifying
10
Licensed in
MS
In the registry since
2020
Specialties on file
2
What do these letters mean?
FNP-BC — Family Nurse Practitioner, Board Certified
A family nurse practitioner certified by the ANCC.

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Practice location Address checks out

971 Lakeland Dr
Jackson, MS 39216-4643
Phone: (601) 200-2000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 401 Baptist Dr Ste 104, Madison, MS 39110-2010 — (601) 605-2383

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 904214 (MS)
Nurse Practitioner Taxonomy 363L00000X · Licence 904214 (MS)

Record details

NPI number1336742410
Entity typeIndividual (Type 1)
GenderFemale
Credentials FNP-BC
Sole proprietorNo
NPI enumeratedNovember 19, 2020
Last updated in NPPESMarch 31, 2022
Certification dateMarch 31, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2016 (10 years in practice)
Group practice St. Dominic Jackson Memorial — 55 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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