Individual
SAMANTHA JO MOODY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
658 E MAIN ST, CENTREVILLE, MI 49032-9627
(269) 467-3228
Mailing address
25 LINDA LN, COLDWATER, MI 49036-1035
(269) 625-0177
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
4704314094
MI
Other
Enumeration date
11/02/2020
Last updated
11/02/2020
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