Provider Demographics
NPI:1780855957
Name:MOORE, JODI (RRT, RCP)
Entity Type:Individual
Prefix:MS
First Name:JODI
Middle Name:
Last Name:MOORE
Suffix:
Gender:F
Credentials:RRT, RCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:99 ASCENSION DR APT C107
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28806-1972
Mailing Address - Country:US
Mailing Address - Phone:828-332-1548
Mailing Address - Fax:
Practice Address - Street 1:99 ASCENSION DR APT C107
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28806-1972
Practice Address - Country:US
Practice Address - Phone:828-332-1548
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-03-17
Last Update Date:2008-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA-38372279C0205X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2279C0205XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, RegisteredCritical Care