Individual
LAKISHA DAVONDA MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5 W QUEENS WAY STE 203, HAMPTON, VA 23669-4084
(757) 964-6297
Mailing address
4060 VICTORIA BLVD APT 107, HAMPTON, VA 23669-4284
(757) 968-0398
(757) 251-3801
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
—
—
Other
Enumeration date
10/19/2020
Last updated
01/18/2021
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