Individual provider · Type 1 NPI

Jacqueline Historian Moore, LPN

Licensed Practical Nurse · Lithonia, GA

NPI number 1659649002 Active

Practice location

6256 Hillandale Dr Apt 803
Lithonia, GA 30058-2432

Call (678) 913-7277 Map

Specialties and licenses

TaxonomyCodeLicense
Licensed Practical Nurse Primary 164W00000XLPN085771 (GA)

Licensed Practical Nurse: An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states.

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About NPI 1659649002

Jacqueline Historian Moore, LPN's National Provider Identifier is 1659649002, issued on Dec 13, 2011. The primary taxonomy on file is Licensed Practical Nurse (164W00000X), and the practice location is in Lithonia, GA. The record was last updated on Jan 22, 2014.