Provider Demographics
NPI:1528830783
Name:MORETTO, NORA LEE
Entity type:Individual
Prefix:
First Name:NORA
Middle Name:LEE
Last Name:MORETTO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:NORA
Other - Middle Name:LEE
Other - Last Name:MORETTO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:355 BLUEFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:BLUEFIELD
Mailing Address - State:WV
Mailing Address - Zip Code:24701-2883
Mailing Address - Country:US
Mailing Address - Phone:304-910-0979
Mailing Address - Fax:
Practice Address - Street 1:355 BLUEFIELD AVE
Practice Address - Street 2:
Practice Address - City:BLUEFIELD
Practice Address - State:WV
Practice Address - Zip Code:24701-2883
Practice Address - Country:US
Practice Address - Phone:304-910-0979
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-23
Last Update Date:2023-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV15687960273747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant