Individual
JENNIFER MOODY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
10080 SW INNOVATION WAY STE 201, PORT ST LUCIE, FL 34987-2129
(772) 344-3811
(772) 344-3890
Mailing address
PO BOX 417, STUART, FL 34995-0417
(772) 223-5665
(772) 223-5646
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
ARNP9241652
FL
Other
Enumeration date
09/18/2013
Last updated
10/09/2020
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