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JENNETTA SHIMELL MOORE LPN
NPI 1629678271
Licensed Practical Nurse in Winston Salem, NC

Active since October 31, 2020
3215 OLD VINEYARD RD, WINSTON SALEM, NC 27103(336) 354-9047 Get Directions Write a Review

NPPES record last updated: October 31, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Jennetta Shimell Moore Lpn NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JENNETTA SHIMELL MOORE LPN (NPI 1629678271) is an individual licensed practical nurse in Winston Salem, North Carolina, licensed in North Carolina (90648) and active in the NPI registry since October 2020.

NPPES Registry Identity

NPI1629678271
Entity TypeIndividualFemale
Primary Taxonomy164W00000X
Provider Legal NameJENNETTA SHIMELL MOORECredential: LPN
Location Address3215 OLD VINEYARD RDWinston Salem, NC 27103-1411
Mailing Address3215 Old Vineyard RdWinston Salem, NC 27103-1411 · (336) 354-9047
Phone(336) 354-9047
Sole ProprietorNo
Enumeration DateOctober 31, 2020
NPPES CertifiedOctober 31, 2020
✔ NPI 1629678271 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyLicensed Practical NurseNursing Service Providers
Taxonomy Code164W00000X
License✔ Licensed in NC · 90648
Definition
A licensed practical nurse 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.
3215 OLD VINEYARD RD, Winston Salem, NC 27103
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Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jennetta Moore's NPI number?

The NPI number for Jennetta Moore is 1629678271. It was assigned to this individual provider in the NPPES registry on October 31, 2020.

Where is Jennetta Moore located?

Jennetta Moore practices at 3215 Old Vineyard Rd, Winston Salem, NC 27103. The listed phone number is (336) 354-9047.

What is Jennetta Moore's specialty?

The primary specialty registered for this NPI is Licensed Practical Nurse with taxonomy code 164W00000X.

When was this NPI record last updated?

The NPPES record for Jennetta Moore was last updated on October 31, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.