Wanda Moore
Individual provider Active NPI Driver · Covington, VA
NPI 1679099501 · NPPES record last updated Jul 21, 2022
Key facts
- NPI
- 1679099501
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Driver 172A00000X
- Practice address
- 140 N Court Ave
Covington, VA 24426-1534 - Phone
- (540) 691-5248
- NPI assigned
- Aug 22, 2017
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Driver | 172A00000X | Yes |
Addresses
Primary practice location
140 N Court Ave
Covington, VA 24426-1534
Mailing address
140 N Court Ave
Covington, VA 24426-1534
Phone (540) 691-5248
Other providers in Covington, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 21, 2022. 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.