Individual
HOLLY LYNN MOEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CNM
Contact information
Practice address
23 MAIN ST, WINTERS, CA 95694-1722
(530) 212-1028
Mailing address
2301 BRYCE LN, DAVIS, CA 95616-6608
(530) 758-3459
Taxonomy
Speciality
Code
Description
License number
State
163WX0002X
High-Risk Obstetric Registered Nurse
285953
CA
367A00000X
Advanced Practice Midwife
Primary
933
CA
Other
Enumeration date
01/08/2007
Last updated
03/07/2013
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