Individual
JOHNNY BURTON MOODY JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP-BC
Contact information
Practice address
3680 ROBINWOOD RD, GASTONIA, NC 28054-1676
(704) 869-9701
Mailing address
6903 PARK SHARON CT, CHARLOTTE, NC 28210-4612
(828) 279-5381
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
5006262
NC
Other
Enumeration date
06/28/2013
Last updated
06/28/2013
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