Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
JACQUELINE HISTORIAN MOORE, LPN
Active Sole ProprietorJACQUELINE HISTORIAN MOORE, LPN is a Licensed Practical Nurse healthcare provider located in LITHONIA, Georgia. NPI 1659649002 is currently active in the NPPES registry. Verify at CMS.
Licensed Practical Nurse · LITHONIA, GA
Registration Details
- NPI Number
- 1659649002
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Dec 13, 2011 (14.664751623755 yrs)
- Last Updated
- Jan 22, 2014
- License
-
LPN085771 (GA)
- Sole Proprietor
- Yes
Practice Information
- Address
-
6256 HILLANDALE DR APT 803LITHONIA, GA, 300582432Browse GA providers · Browse ZIP 30058
- Phone
- 6789137277
- Primary Specialty
-
Licensed Practical Nurse
164W00000X
Other Licensed Practical Nurse Providers in LITHONIA, GA
| Name | Credential | NPI |
|---|---|---|
| PHEDELINE NICHOLAS | — | 1750557187 |
| MRS. ROSSALIND MARIA THOMPSON | LPN | 1952607814 |
| AYANNA TENAY HARRIS | LPN | 1003167669 |
| MS. VICKIE J IVEY | LPN | 1033544184 |
| VANIECE NOBLE | — | 1932527165 |
| MONICA JONES | LPN | 1104233444 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.