Provider Demographics
NPI:1316772304
Name:MOORE, DENIKA L (LD CPS FPM)
Entity type:Individual
Prefix:
First Name:DENIKA
Middle Name:L
Last Name:MOORE
Suffix:
Gender:F
Credentials:LD CPS FPM
Other - Prefix:
Other - First Name:DENIKA
Other - Middle Name:
Other - Last Name:MOORE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MOTHER WITH ATTITUDE
Mailing Address - Street 1:1201 W PEACHTREE ST NW STE 2625
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30309-3499
Mailing Address - Country:US
Mailing Address - Phone:706-578-3853
Mailing Address - Fax:
Practice Address - Street 1:815 HARRISON SQ APT B2
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:GA
Practice Address - Zip Code:30507-5057
Practice Address - Country:US
Practice Address - Phone:470-844-8629
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-07
Last Update Date:2024-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula