Moore, Carissa Laverne
Moore, Carissa Laverne is an sole proprietor health care provider with primary practice located at 1680 S Greathouse Drive , Atoka OK 74525. She recently has only one registered license in Nursing Service Related Providers / Personal Care Attendant, which is considered as her primary health care specialty. Moore, Carissa Laverne can be contacted via phone (580) 297-6965.Contact Information
Primary practice address
1680 S Greathouse Drive
Atoka OK 74525
Phone: (580) 297-6965
Fax: (580) 324-4181
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Nursing Service Related Providers / Personal Care Attendant | 3747P1801X |
Profile Details
NPI number | 1588245013 |
---|---|
LBN Legal business name | Moore, Carissa Laverne |
Credentials | |
Entity | Individual |
Sole proprietor 1 | Yes |
Enumeration date | Apr 16th, 2021 |
Last updated | Apr 16th, 2021 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1588245013 | NPPES |
Oklahoma | MEDICAID | 100683770A |
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