# MRS. AMBER MOODY

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1255934907
- **Gender:** F
- **Credential:** DNP, CNP, PMHNP-BC

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 163W00000X | Registered Nurse | N261366711 | WA | — |
| 163W00000X | Registered Nurse | R033051 | SD | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | CP002480 | SD | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | N361369739 | WA | — |

## Other

- **Enumeration date:** 11/17/2020
- **Last updated:** 11/13/2022