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General NPI Number Information
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NPI Number | 1558668954
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Entity Type | Individual
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Provider Name | NANCI WHALEY MOODY PHARMD.
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Gender | Female
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Dates
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Enumeration Date | 02/21/2011
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Last Update Date | 02/21/2011
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Provider Practice Location Address
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Address Line | 2453 BOYDS CREEK HWY STE 102
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City | SEVIERVILLE
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State | TN
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Zip | 37876-0676
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Country | US
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Telephone | 865-428-7439
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Fax | 865-453-4515
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Provider Business Mailing Address
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Address Line | 1205 RACHEL ST
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City | SEVIERVILLE
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State | TN
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Zip | 37876-0581
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Country | US
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Telephone | 865-428-1076
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 26681
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 15691
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License Number State | AL
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