Provider Demographics
NPI:1285107193
Name:MOORER, CHINEIKA JEANINE (LPN)
Entity type:Individual
Prefix:MS
First Name:CHINEIKA
Middle Name:JEANINE
Last Name:MOORER
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:CHINEIKA
Other - Middle Name:JEANINE
Other - Last Name:MOORER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPN
Mailing Address - Street 1:4753 E 86TH ST
Mailing Address - Street 2:
Mailing Address - City:GARFIELD HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44125-1331
Mailing Address - Country:US
Mailing Address - Phone:216-551-7676
Mailing Address - Fax:
Practice Address - Street 1:4753 E 86TH ST
Practice Address - Street 2:
Practice Address - City:GARFIELD HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44125-1331
Practice Address - Country:US
Practice Address - Phone:216-551-7676
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-03
Last Update Date:2019-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH159402164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse