Provider Demographics
NPI:1699150847
Name:MOORE, CHRISHANDA (CNA)
Entity type:Individual
Prefix:MISS
First Name:CHRISHANDA
Middle Name:
Last Name:MOORE
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6027 TROTTERS RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28227-4050
Mailing Address - Country:US
Mailing Address - Phone:980-201-1736
Mailing Address - Fax:704-569-0822
Practice Address - Street 1:6027 TROTTERS RIDGE RD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28227-4050
Practice Address - Country:US
Practice Address - Phone:980-201-1736
Practice Address - Fax:704-569-0822
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-29
Last Update Date:2015-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC333081372600000X, 374U00000X, 376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide
No372600000XNursing Service Related ProvidersAdult Companion
No374U00000XNursing Service Related ProvidersHome Health Aide