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NPI Code Detail

MEDICARE: BRITTANY MOORE

MEDICARE:   BRITTANY  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
1164W00000XLicensed Practical NurseLPN.144057.MEDS-IVOH

General Provider Information

NPI Number : 1558808394
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRITTANY MOORE
Provider Business Mailing Address
First Line : 4917 WOODLAND HILLS BLVD
Second Line :
City : DAYTON
State : OH
Zip : 45414-4755
Country : US
Telephone Number : 937-668-5818
Fax Number :
Provider Business Practice Location Address
First Line : 4917 WOODLAND HILLS BLVD
Second Line :
City : DAYTON
State : OH
Zip : 45414-4755
Country : US
Telephone Number : 937-668-5818
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/31/2017
Last Update Date : 01/31/2017

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Directions to “ BRITTANY MOORE ” Practice Location

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