Healthcare Provider Details

I. General information

NPI: 1770190332
Provider Name (Legal Business Name): MS. CIERRA M MOYE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/28/2020
Last Update Date: 09/28/2020
Certification Date: 09/26/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5750 ARBORWOOD CT APT B
COLUMBUS OH
43229-3468
US

IV. Provider business mailing address

5750 ARBORWOOD CT APT B
COLUMBUS OH
43229-3468
US

V. Phone/Fax

Practice location:
  • Phone: 614-902-6329
  • Fax:
Mailing address:
  • Phone: 614-902-6329
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License NumberTS976543
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: