MISS TINJA CAMILLA MOORE RN NPI 1861450355

NPI Information

NPI: 1861450355
Provider Name: MISS TINJA CAMILLA MOORE, RN
Classification: Registered Nurse - 163WH0200X
Entity Type: Individual

Specialization: Home Health

Address:
2647 N HOLTON ST
MILWAUKEE, WI
ZIP 53212
Phone: (414) 265-5113
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MISS Tinja Camilla Moore, RN is a home health registered nurse in Milwaukee, WI. MISS Tinja Camilla Moore, RN NPI is 1861450355. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

2647 N HOLTON ST
MILWAUKEE, WI
ZIP 53212-928
Phone: (414) 265-5113

The enumeration date for this NPI number is 5/3/2006 and was last updated on 7/9/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	163WH0200X	Registered Nurse	Home Health		WISCONSIN	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	39991300	MEDICAID	WISCONSIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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