Provider Demographics
NPI:1174915037
Name:MOONIE, RASHEENA TIARA (NP)
Entity type:Individual
Prefix:
First Name:RASHEENA
Middle Name:TIARA
Last Name:MOONIE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:RASHEENA
Other - Middle Name:TIARA
Other - Last Name:PARKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:1201 W PEACHTREE ST NW STE 2625
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30309-3499
Mailing Address - Country:US
Mailing Address - Phone:404-747-8511
Mailing Address - Fax:404-393-5482
Practice Address - Street 1:5750 PINELAND DR
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-5300
Practice Address - Country:US
Practice Address - Phone:214-221-0855
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-02
Last Update Date:2025-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5007495363LW0102X
TX1182759363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCNCN076AMedicare UPIN