| Provider / Organization | NPI | Date Certified |
|---|---|---|
| MYESHA D MOORE | 1710570494 | 2021-02-14 |
Myesha D Moore is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1710570494. Registration indicates Myesha D Moore is a provider of services with a specialization in Nursing Service Providers, Licensed Practical Nurse (Licensed Practical Nurse, ) (Licensed Practical Nurse, Nursing Service Providers)
| Entity Type | Individual |
| Provider Name | Myesha D Moore LPN |
| Practice Office Address | 250 BRAY ST ATHENS, GA US |
| Practice Office Telephone | 7063896789 |
| Mailing Address | 155 MEADOW LN HULL, GA 306463842 US |
| Business Telephone | 6785985945 |
| Code | Practice | License No State |
|---|---|---|
| 164W00000X PRIMARY | Nursing Service Providers Licensed Practical Nurse Licensed Practical Nurse Licensed Practical Nurse Nursing Service Providers | 5241012
FL |