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NPI Code Detail

MEDICARE: WHITNEY MOODY NP

MEDICARE: WHITNEY MOODY NP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse PractitionerMOOD-KCJ61NC
2363LF0000XFamily Nurse Practitioner5015013NC

General Provider Information

NPI Number : 1730858226
Entity Type Code : Individual
Provider Name (Legal Business Name) : WHITNEY MOODY NP
Provider Business Mailing Address
First Line : 880 UPPER GLADY FORK RD
Second Line :
City : CANDLER
State : NC
Zip : 28715-9145
Country : US
Telephone Number : 828-337-4271
Fax Number :
Provider Business Practice Location Address
First Line : 1510 HEBRON RD
Second Line :
City : HENDERSONVILLE
State : NC
Zip : 28739-4794
Country : US
Telephone Number : 828-693-8461
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/08/2021
Last Update Date : 09/16/2021

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