Provider Demographics
NPI:1609450436
Name:MOORER, RICKSHA L
Entity Type:Individual
Prefix:MISS
First Name:RICKSHA
Middle Name:L
Last Name:MOORER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2700 WASHINGTON AVE APT 901
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44113-2627
Mailing Address - Country:US
Mailing Address - Phone:216-609-4309
Mailing Address - Fax:
Practice Address - Street 1:2700 WASHINGTON AVE APT 901
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44113-2627
Practice Address - Country:US
Practice Address - Phone:216-609-4309
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-07
Last Update Date:2021-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide