Provider Demographics
NPI:1972399764
Name:MOORE, SHYKELA L
Entity type:Individual
Prefix:
First Name:SHYKELA
Middle Name:L
Last Name:MOORE
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 ARNETT BLVD
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24540-3424
Mailing Address - Country:US
Mailing Address - Phone:434-710-2847
Mailing Address - Fax:
Practice Address - Street 1:250 ARNETT BLVD
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:VA
Practice Address - Zip Code:24540-3424
Practice Address - Country:US
Practice Address - Phone:434-710-2847
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-17
Last Update Date:2025-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health