Individual
RAECHELLE ANGELEE MOFFETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CEO, LVN
Contact information
Practice address
5702 GREENGATE DR APT D, KILLEEN, TX 76543-9006
(254) 245-8058
(254) 699-4189
Mailing address
5702 GREENGATE DR APT D, KILLEEN, TX 76543-9006
(254) 681-7975
(254) 699-4189
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
327311
TX
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
251J00000X
Nursing Care Agency
—
—
253Z00000X
In Home Supportive Care Agency
—
—
261QA0600X
Adult Day Care Clinic/Center
Primary
—
—
310400000X
Assisted Living Facility
—
—
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
—
—
320700000X
Physical Disabilities Residential Treatment Facility
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
—
—
332U00000X
Home Delivered Meals
—
—
372500000X
Chore Provider
—
—
372600000X
Adult Companion
—
—
374U00000X
Home Health Aide
—
—
Other
Enumeration date
08/21/2021
Last updated
06/07/2023
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