MEDICARE: ESSENCE MOORE

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
1	3747P1801X	Personal Care Attendant

General Provider Information

NPI Number	:	1215735303
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ESSENCE MOORE

Provider Business Mailing Address
First Line	:	3100 FURMAN LN APT 203
Second Line	:
City	:	ALEXANDRIA
State	:	VA
Zip	:	22306-1029
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1609 19TH ST SE
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20020-5417
Country	:	US
Telephone Number	:	202-381-8380
Fax Number	:

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

Provider Enumeration Date	:	03/04/2025
Last Update Date	:	03/04/2025

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Directions to “ ESSENCE MOORE ” Practice Location

Language	Start Address	Practice Location

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