Provider Demographics
NPI:1447079926
Name:MOORE, DAVVIE
Entity type:Individual
Prefix:
First Name:DAVVIE
Middle Name:
Last Name:MOORE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17800 CHILLICOTHE RD STE 225
Mailing Address - Street 2:
Mailing Address - City:CHAGRIN FALLS
Mailing Address - State:OH
Mailing Address - Zip Code:44023-4831
Mailing Address - Country:US
Mailing Address - Phone:440-384-3196
Mailing Address - Fax:
Practice Address - Street 1:17800 CHILLICOTHE RD STE 225
Practice Address - Street 2:
Practice Address - City:CHAGRIN FALLS
Practice Address - State:OH
Practice Address - Zip Code:44023-4831
Practice Address - Country:US
Practice Address - Phone:440-384-3196
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-10
Last Update Date:2024-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374J00000XNursing Service Related ProvidersDoulaGroup - Single Specialty