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General NPI Number Information
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NPI Number | 1104631936
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Entity Type | Individual
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Provider Name | MADISON ANN MOYER
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Gender | Female
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Dates
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Enumeration Date | 02/10/2025
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Last Update Date | 07/17/2025
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Provider Practice Location Address
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Address Line | 5268 W UNIVERSITY DR
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City | MCKINNEY
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State | TX
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Zip | 75071-7822
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Country | US
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Telephone | 463-814-3278
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Fax |
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Provider Business Mailing Address
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Address Line | 20 COUNTRY LAKE DR
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City | CARROLLTON
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State | TX
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Zip | 75006-4703
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 1206554
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License Number State | TX
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