Individual
BRENDA K. MOODY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
8110 COUNTY ROAD 44 LEG A, LEESBURG, FL 34788-3704
(352) 323-8868
(352) 323-8865
Mailing address
8110 COUNTY ROAD 44 LEG A, LEESBURG, FL 34788-3704
(352) 323-8868
(352) 323-8865
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
ARNP 9335818
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00121720
—
MS
05
—
006434500
—
FL
Enumeration date
02/26/2007
Last updated
07/22/2014
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