Jennifer Heine Moore, LVN

Primary specialty

Licensed Vocational NurseTaxonomy code 164X00000X

License

332189 Issued in TX

Practice address

315 S Grand Saline St
Canton, TX 75103-1355

Phone

(469) 474-1777

NPI assigned

Jul 31, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1532995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532995200000",
    "number": "1942788104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1494",
            "city": "FORNEY",
            "state": "TX",
            "postal_code": "751261494",
            "telephone_number": "469-474-1777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 S GRAND SALINE ST",
            "city": "CANTON",
            "state": "TX",
            "postal_code": "751031355",
            "telephone_number": "469-474-1777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "JENNIFER",
        "middle_name": "HEINE",
        "credential": "LVN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-31",
        "last_updated": "2018-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "CA",
            "license": "692539",
            "primary": false
        },
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "TX",
            "license": "332189",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patti Ruth Meyers-Jones, MS, PT, CLT
• Breanne Miles, AGNP
• Riley Anne Milligan
• Mindful Methodology
• Jennifer Elaine Moore, RN BSN
• Mary Moss, RBT
• John Charles Motley
• Chet J Nix, DC
• Kelsey Lauren Nixon, RN
• Kenneth Wayne Nixon, MD

• Licensed Vocational Nurse in Canton, TX
• Providers in Canton, TX by specialty
• Licensed Vocational Nurse in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2018; 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.