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NPI Code Detail

MEDICARE: TASHAUNA MOORE

MEDICARE:   TASHAUNA  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
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General Provider Information

NPI Number : 1649021734
Entity Type Code : Individual
Provider Name (Legal Business Name) : TASHAUNA MOORE
Provider Business Mailing Address
First Line : 413 JACKSON ST
Second Line :
City : FAIRMONT
State : NC
Zip : 28340-1711
Country : US
Telephone Number : 910-774-2052
Fax Number :
Provider Business Practice Location Address
First Line : 416 FOXFIRE DRIVE
Second Line :
City : ORRUM
State : NC
Zip : 28369
Country : US
Telephone Number : 910-774-2052
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/28/2024
Last Update Date : 03/28/2024

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Directions to “ TASHAUNA MOORE ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.