MEDICARE: MS. TIA M MOORE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	372500000X	Chore Provider
2	372600000X	Adult Companion
3	3747A0650X	Attendant Care Provider
4	3747P1801X	Personal Care Attendant
5	374U00000X	Home Health Aide
6	376J00000X	Homemaker

General Provider Information

NPI Number	:	1134321359
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. TIA M MOORE

Provider Business Mailing Address
First Line	:	6897 W M 21
Second Line	:
City	:	SAINT JOHNS
State	:	MI
Zip	:	48879-9509
Country	:	US
Telephone Number	:	202-489-4842
Fax Number	:	989-224-1925

Provider Business Practice Location Address
First Line	:	6897 W M 21
Second Line	:
City	:	SAINT JOHNS
State	:	MI
Zip	:	48879-9509
Country	:	US
Telephone Number	:	202-489-4842
Fax Number	:	989-224-1925

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/01/2007
Last Update Date	:	09/11/2025

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Directions to “ MS. TIA M MOORE ” Practice Location

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