Healthcare Provider Details

I. General information

NPI: 1063327724
Provider Name (Legal Business Name): LASHONDA MOORE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/17/2026
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

202 TERRACE CT
GREENVILLE NC
27834-8769
US

IV. Provider business mailing address

202 TERRACE CT
GREENVILLE NC
27834-8769
US

V. Phone/Fax

Practice location:
  • Phone: 252-717-6848
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: