NPI 1659649002

Jacqueline Historian Moore, LPN

Practitioner Licensed Practical Nurse Lithonia, GA

Practice location

Address: 6256 Hillandale Dr APT 803, Lithonia, GA 30058-2432
Phone: (678) 913-7277

Registered specialties

Licensed Practical Nurse Primary

Nursing Service Providers Taxonomy 164W00000X Licence LPN085771 (GA)

Other Licensed Practical Nurse providers in Georgia →

Registry record

NPI: 1659649002
Entity type: Individual
Sex (as registered): Female
NPI issued: 13 Dec 2011
Record last updated: 22 Jan 2014

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.