Shonda Lashay Moore-Stevens
Individual provider Active NPI Private Vehicle · Alberta, VA
NPI 1669933438 · NPPES record last updated Mar 26, 2019
Key facts
- NPI
- 1669933438
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Private Vehicle 347C00000X
- License
- T64272744 (VA)
- Practice address
- 775 Prestwood Rd
Alberta, VA 23821 - Phone
- (804) 677-0732
- Fax
- (434) 532-4294
- NPI assigned
- Mar 26, 2019
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| T64272744 | VA | MD | Private Vehicle |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Private Vehicle | 347C00000X | T64272744 | VA | Yes |
Addresses
Primary practice location
775 Prestwood Rd
Alberta, VA 23821
Mailing address
775 Prestwood Rd
Alberta, VA 23821
Phone (804) 677-0732
Other providers in Alberta, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 26, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.