Most Relevant Information
Provider Data
| NPI Number: | 1003209313 |
| Provider Name: | NEDRA MOODY |
| Entity Type: | Individual |
| Taxonomy Code: | 164W00000X |
| Specialty: | Licensed Practical Nurse |
| License Number: | PN293768 |
Most Important Dates
| Enumeration Date: | 03/11/2015 |
| Last Updated: | 03/11/2015 |
Provider Practice Location
7930 NITTANY VALLEY DR
MILL HALL
PA
177518805
Practice Location Phone/Fax
| Phone: | 5707264306 |
| Fax: |
Provider Mailing Location
7930 NITTANY VALLEY DR
MILL HALL
PA
177518805
Provider Mailing Phone/Fax
| Phone: | 5707264306 |
| Fax: |