Individual
TAMARA N MOODY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
2222 N NEVADA AVE, COLORADO SPRINGS, CO 80907-6819
(719) 776-8040
Mailing address
401 E SPRUCE ST, GARDEN CITY, KS 67846-5679
(620) 272-2222
(620) 272-2755
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
78654
KS
363L00000X
Nurse Practitioner
C-APN.0004179-C-NP
CO
363LA2100X
Acute Care Nurse Practitioner
Primary
C-APN.0004179-C-NP
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
78654
LICENSE
KS
Enumeration date
04/02/2019
Last updated
06/13/2022
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