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General NPI Number Information
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NPI Number | 1902847056
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Entity Type | Individual
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Provider Name | SANDRA HILL MOODY FNP
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Gender | Female
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Dates
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Enumeration Date | 06/09/2006
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Last Update Date | 02/23/2011
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Provider Practice Location Address
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Address Line | 6715 W HIGHWAY 98
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City | PENSACOLA
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State | FL
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Zip | 32506-5923
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Country | US
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Telephone | 850-453-6737
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Fax | 850-453-1196
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Provider Business Mailing Address
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Address Line | PO BOX 18868
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City | PENSACOLA
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State | FL
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Zip | 32523-8868
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Country | US
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Telephone | 850-994-5660
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Fax | 850-994-5841
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | AP1243
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | ARNP9179625
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License Number State | FL
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