Shawanda Lassettte Moore, MSN, BS, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

RN9312768 Issued in FL

Practice address

10636 3Rd St N Apt D
St Petersburg, FL 33716-3291

Phone

(813) 573-9733

NPI assigned

Jul 10, 2024

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor of Science, Master of Science - Nursing, Registered Nurse

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1720569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720569600000",
    "number": "1225875974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10636 3RD ST N APT D",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337163291",
            "telephone_number": "813-573-9733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10636 3RD ST N APT D",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337163291",
            "telephone_number": "813-573-9733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "SHAWANDA",
        "middle_name": "LASSETTTE",
        "name_prefix": "Ms.",
        "credential": "MSN, BS, RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-07-10",
        "last_updated": "2024-07-10",
        "certification_date": "2024-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse",
            "state": "FL",
            "license": "RN9312768",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lily Mae Moore, LMT
• Madison Moore
• Mariah Dawn Moore, M.S. CF-SLP
• Natalie Nicole Moore, CRNA
• Sandra M Moore, R.PH.
• Sherrie Faith Moore, M.D.
• Macklyn Kelley Moorhead, LCSW
• Amaya Kaley Mora
• Ashley Ann Morales
• Bonnie Morales, FNP-C

• Registered Nurse in St Petersburg, FL
• Providers in St Petersburg, FL by specialty
• Registered Nurse in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.