Provider Demographics
NPI:1013680305
Name:MOTEN, AKEIBIA (RN)
Entity type:Individual
Prefix:
First Name:AKEIBIA
Middle Name:
Last Name:MOTEN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:813 E PECAN AVE
Mailing Address - Street 2:
Mailing Address - City:WACO
Mailing Address - State:TX
Mailing Address - Zip Code:76704-2634
Mailing Address - Country:US
Mailing Address - Phone:254-715-9660
Mailing Address - Fax:
Practice Address - Street 1:813 E PECAN AVE
Practice Address - Street 2:
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76704-2634
Practice Address - Country:US
Practice Address - Phone:254-715-9660
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-01
Last Update Date:2022-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
342000000X, 374U00000X, 251E00000X, 253Z00000X
TX1079220163WH0200X
TX353005164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WH0200XNursing Service ProvidersRegistered NurseHome HealthGroup - Multi-Specialty
No342000000XTransportation ServicesTransportation Network CompanyGroup - Multi-Specialty
No374U00000XNursing Service Related ProvidersHome Health AideGroup - Multi-Specialty
No251E00000XAgenciesHome Health
No164X00000XNursing Service ProvidersLicensed Vocational NurseGroup - Multi-Specialty
No253Z00000XAgenciesIn Home Supportive Care