JACQUELINE HISTORIAN MOORE LPN
NPI 1659649002
Licensed Practical Nurse in Lithonia, GA

Q: What is Jacqueline Moore's NPI number?

The NPI number for Jacqueline Moore is 1659649002. It was assigned to this individual provider in the NPPES registry on December 13, 2011.

Q: What is Jacqueline Moore's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Jacqueline Moore was last updated on January 22, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.

Active since December 13, 2011

6256 HILLANDALE DR APT 803, LITHONIA, GA 30058(678) 913-7277 Get Directions Write a Review

NPPES record last updated: January 22, 2014. Verified against the NPPES registry weekly; last sync: August 30, 2026.

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About Jacqueline Historian Moore Lpn NPPES

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

JACQUELINE HISTORIAN MOORE LPN (NPI 1659649002) is an individual licensed practical nurse in Lithonia, Georgia, licensed in Georgia (LPN085771) and active in the NPI registry since December 2011.

NPPES Registry Identity

NPI1659649002

Entity TypeIndividualFemale

Primary Taxonomy164W00000X

Provider Legal NameJACQUELINE HISTORIAN MOORECredential: LPN

Location Address6256 HILLANDALE DR APT 803Lithonia, GA 30058-2432

Mailing Address6256 Hillandale Dr Apt 803Lithonia, GA 30058-2432 · (678) 913-7277

Phone(678) 913-7277

Sole ProprietorYes

Enumeration DateDecember 13, 2011

Last NPPES UpdateJanuary 22, 2014

✔ NPI 1659649002 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 GA · LPN085771

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.

6256 HILLANDALE DR APT 803, Lithonia, GA 30058

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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 Jacqueline Moore's NPI number?

The NPI number for Jacqueline Moore is 1659649002. It was assigned to this individual provider in the NPPES registry on December 13, 2011.

Where is Jacqueline Moore located?

Jacqueline Moore practices at 6256 Hillandale Dr Apt 803, Lithonia, GA 30058. The listed phone number is (678) 913-7277.

What is Jacqueline 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 Jacqueline Moore was last updated on January 22, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.