Healthcare Provider Details

I. General information

NPI: 1023285319
Provider Name (Legal Business Name): ANGIE RAY MOYE FNP, B.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/15/2008
Last Update Date: 03/05/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6602 WATERS AVE BLDG C
SAVANNAH GA
31406-2778
US

IV. Provider business mailing address

6602 WATERS AVE BLDG C
SAVANNAH GA
31406-2778
US

V. Phone/Fax

Practice location:
  • Phone: 912-354-7676
  • Fax: 912-354-2181
Mailing address:
  • Phone: 912-354-7676
  • Fax: 912-354-2181

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberRN164257
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: