Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Jacqueline Historian Moore, LPN

Individual provider Licensed Practical Nurse · NPI 1659649002

Jacqueline Historian Moore, LPN is a Licensed Practical Nurse in Lithonia, Georgia. Practices as a sole proprietor. Licensed in Georgia.

Licensed in
GA
In the registry since
2011
What do these letters mean?
LPN — Licensed Practical Nurse
A licensed nurse who works under the direction of an RN or physician.

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Practice location Address checks out

6256 Hillandale Dr Apt 803
Lithonia, GA 30058-2432
Phone: (678) 913-7277
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Licensed Practical Nurse (primary) Taxonomy 164W00000X · Licence LPN085771 (GA)

Record details

NPI number1659649002
Entity typeIndividual (Type 1)
GenderFemale
Credentials LPN
Sole proprietorYes
NPI enumeratedDecember 13, 2011
Last updated in NPPESJanuary 22, 2014

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