Healthcare Provider Details

I. General information

NPI: 1619825627
Provider Name (Legal Business Name): JAYLA MARIE MOORER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/17/2026
Last Update Date: 03/17/2026
Certification Date: 03/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1900 NE 112TH TER
KANSAS CITY MO
64155-1274
US

IV. Provider business mailing address

1900 NE 112TH TER
KANSAS CITY MO
64155-1274
US

V. Phone/Fax

Practice location:
  • Phone: 816-905-7171
  • Fax:
Mailing address:
  • Phone: 816-905-7171
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: