# DEASIA MOORE

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1902254485
- **Gender:** F

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 163WM0705X | Medical-Surgical Registered Nurse | 722968 | NY | Yes |
| 164W00000X | Licensed Practical Nurse | 323577 | NY | — |

## Other

- **Enumeration date:** 05/25/2016
- **Last updated:** 11/21/2024