Provider Demographics
NPI:1144905332
Name:MOORER, TANA CARLA
Entity type:Individual
Prefix:
First Name:TANA
Middle Name:CARLA
Last Name:MOORER
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 1:30 WOOLF AVE
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44312-1542
Mailing Address - Country:US
Mailing Address - Phone:330-826-1675
Mailing Address - Fax:
Practice Address - Street 1:30 WOOLF AVE
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44312-1542
Practice Address - Country:US
Practice Address - Phone:330-826-1675
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-16
Last Update Date:2023-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347C00000XTransportation ServicesPrivate Vehicle
No342000000XTransportation ServicesTransportation Network Company
No174200000XOther Service ProvidersMeals
No253Z00000XAgenciesIn Home Supportive Care