Provider Demographics
NPI:1689338097
Name:MOORE, ZAKIA
Entity Type:Individual
Prefix:
First Name:ZAKIA
Middle Name:
Last Name:MOORE
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 1:5680 COACH DR W APT A
Mailing Address - Street 2:
Mailing Address - City:KETTERING
Mailing Address - State:OH
Mailing Address - Zip Code:45440-2741
Mailing Address - Country:US
Mailing Address - Phone:859-388-4777
Mailing Address - Fax:
Practice Address - Street 1:5680 COACH DR W APT A
Practice Address - Street 2:
Practice Address - City:KETTERING
Practice Address - State:OH
Practice Address - Zip Code:45440-2741
Practice Address - Country:US
Practice Address - Phone:859-388-4777
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-22
Last Update Date:2021-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health