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Jacqueline Historian Moore, LPN
Licensed Practical Nurse in Lithonia, Georgia
NPI 1659649002

Jacqueline Historian Moore is a Licensed Practical Nurse based in Lithonia, GA. Jacqueline Historian Moore practices in Lithonia, GA and has the professional credentials of LPN. The NPI Number for Jacqueline Historian Moore is 1659649002 and holds a License No. LPN085771 (Georgia).

The current practice location address for Jacqueline Historian Moore is 6256 Hillandale Dr Apt 803, Lithonia, GA and can be reached out via phone at 678-913-7277.

Location: 6256 Hillandale Dr Apt 803, Lithonia, GA, 30058-2432
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1659649002
Provider Name
Jacqueline Historian Moore
Credential
LPN
Provider Entity Type
Individual
Gender
Female
Address
6256 Hillandale Dr Apt 803, Lithonia, GA, 30058-2432
Phone Number
678-913-7277
Fax Number
Provider Enumeration Date
12/13/2011
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
6256 Hillandale Dr Apt 803
City
Lithonia
State
Georgia
Zip
30058-2432
Phone Number
678-913-7277
Fax Number
person
Provider Business Mailing Address Details
Address
6256 Hillandale Dr Apt 803
City
Lithonia
State
Georgia
Zip
30058-2432
Phone Number
678-913-7277
Fax Number
person
Provider's Taxonomy Details 1
Type
Nursing Service Providers
Classification
Licensed Practical Nurse
Speciality
-
Taxonomy
164W00000X
License No.
LPN085771 (Georgia)
Definition
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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