Provider Demographics
NPI:1538036777
Name:TONEY-MOORE, LAWANDA F
Entity type:Individual
Prefix:
First Name:LAWANDA
Middle Name:F
Last Name:TONEY-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 1:8311 42ND AVE
Mailing Address - Street 2:
Mailing Address - City:KENOSHA
Mailing Address - State:WI
Mailing Address - Zip Code:53142-4918
Mailing Address - Country:US
Mailing Address - Phone:262-527-2116
Mailing Address - Fax:262-364-3067
Practice Address - Street 1:8311 42ND AVE
Practice Address - Street 2:
Practice Address - City:KENOSHA
Practice Address - State:WI
Practice Address - Zip Code:53142-4918
Practice Address - Country:US
Practice Address - Phone:262-527-2116
Practice Address - Fax:262-364-3067
Is Sole Proprietor?:No
Enumeration Date:2025-10-22
Last Update Date:2025-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ILN23100163246RP1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy