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NPI Code Detail

MEDICARE: TEEYANA PRECIOUS MOORE B.S

MEDICARE: TEEYANA PRECIOUS MOORE B.S
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1253Z00000XIn Home Supportive Care Agency

General Provider Information

NPI Number : 1114709730
Entity Type Code : Individual
Provider Name (Legal Business Name) : TEEYANA PRECIOUS MOORE B.S
Provider Business Mailing Address
First Line : 3212 MCGEE HILL DR
Second Line :
City : CHARLOTTE
State : NC
Zip : 28216-7726
Country : US
Telephone Number : 704-713-2804
Fax Number :
Provider Business Practice Location Address
First Line : 3212 MCGEE HILL DR
Second Line :
City : CHARLOTTE
State : NC
Zip : 28216-7726
Country : US
Telephone Number : 980-422-3673
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/18/2023
Last Update Date : 06/04/2025

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