Provider Demographics
NPI:1104684356
Name:MOORE, JANISHA E
Entity type:Individual
Prefix:MISS
First Name:JANISHA
Middle Name:E
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 1:1860 QUEEN CITY AVE APT 116
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45214-1480
Mailing Address - Country:US
Mailing Address - Phone:513-516-2341
Mailing Address - Fax:
Practice Address - Street 1:547 ELBERON AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45205-2497
Practice Address - Country:US
Practice Address - Phone:513-635-4372
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-12
Last Update Date:2024-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant