Most Relevant Information
Provider Data
| NPI Number: | 1003481524 |
| Provider Name: | LAVONDA MOORE STNA |
| Entity Type: | Individual |
| Taxonomy Code: | 376K00000X |
| Specialty: | Nurse's Aide |
| License Number: | 401842620416 |
Most Important Dates
| Enumeration Date: | 05/26/2021 |
| Last Updated: | 05/26/2021 |
Provider Practice Location
3116 MURDOCK AVE
CINCINNATI
OH
452052241
Practice Location Phone/Fax
| Phone: | 5134854295 |
| Fax: |
Provider Mailing Location
3116 MURDOCK AVE
CINCINNATI
OH
452052241
Provider Mailing Phone/Fax
| Phone: | 5134854295 |
| Fax: |