Healthcare Provider Details

I. General information

NPI: 1902120173
Provider Name (Legal Business Name): LAURA ANN MOYER PMHCNS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/17/2010
Last Update Date: 06/27/2025
Certification Date: 06/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8211 MAYFIELD RD
CHESTERLAND OH
44026-2508
US

IV. Provider business mailing address

8211 MAYFIELD RD
CHESTERLAND OH
44026-2508
US

V. Phone/Fax

Practice location:
  • Phone: 440-533-1009
  • Fax: 440-273-7055
Mailing address:
  • Phone: 440-533-1009
  • Fax: 440-273-7055

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SP0809X
TaxonomyAdult Psychiatric/Mental Health Clinical Nurse Specialist
License NumberCOA 11378-NS
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: