Provider Demographics
NPI:1407668635
Name:MOORE-VASSER, DAVION GERMON
Entity type:Individual
Prefix:
First Name:DAVION
Middle Name:GERMON
Last Name:MOORE-VASSER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4749 MEREDITH AVE
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68104-2453
Mailing Address - Country:US
Mailing Address - Phone:402-201-9167
Mailing Address - Fax:
Practice Address - Street 1:4749 MEREDITH AVE
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68104-2453
Practice Address - Country:US
Practice Address - Phone:402-201-9167
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-24
Last Update Date:2025-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care