What is Marquita Moore's NPI number?

The NPI number assigned to this healthcare provider is 1720814619, enumerated as a individual on September 9, 2024.

Where is the provider located?

The provider is located at 3309 S KINGSHIGHWAY BLVD SAINT LOUIS, MO 63139 and the phone number is (314) 206-3700.

What is the provider's specialty?

The provider's specialty is Licensed Practical Nurse with taxonomy code 164W00000X.

MARQUITA LANAE ELDRIDGE MOORE LPN - NPI 1720814619 - Licensed Practical Nurse in Saint Louis, MO

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About Marquita Lanae Eldridge Moore Lpn NPPES

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

MARQUITA LANAE ELDRIDGE MOORE LPN (NPI 1720814619) is an individual licensed practical nurse in Saint Louis, Missouri, licensed in Louisiana (280083) and active in the NPI registry since September 2024.

NPPES Registry Identity

NPI1720814619

Entity TypeIndividualFemale

Primary Taxonomy164W00000X

Provider Legal NameMARQUITA LANAE ELDRIDGE MOORECredential: LPN

Location Address3309 S KINGSHIGHWAY BLVDSaint Louis, MO 63139-1101

Mailing Address3309 S Kingshighway BlvdSaint Louis, MO 63139-1101 · (314) 206-3700 · Fax (314) 206-3708

Phone(314) 206-3700

Fax(314) 206-3708

Sole ProprietorNo

Enumeration DateSeptember 9, 2024

NPPES CertifiedSeptember 9, 2024

✔ NPI 1720814619 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 LA · 280083

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.

3309 S KINGSHIGHWAY BLVD, Saint Louis, MO 63139

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