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NPI Code Detail

MEDICARE: MS. KANIKA SHUKURA MOXLEY RN, BSN

MEDICARE: MS. KANIKA SHUKURA MOXLEY RN, BSN
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
1163W00000XRegistered Nurse22 522778NY

General Provider Information

NPI Number : 1013227206
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. KANIKA SHUKURA MOXLEY RN, BSN
Provider Business Mailing Address
First Line : 579 KATHRINE STREET
Second Line :
City : ORLANDO
State : FL
Zip : 32810
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 950 NORTON ST
Second Line :
City : ROCHESTER
State : NY
Zip : 14621-3732
Country : US
Telephone Number : 585-719-9799
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/21/2010
Last Update Date : 06/18/2012

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