Individual
JANNA MULLIS MOODY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
1218 ALICE ST, WAYCROSS, GA 31501-4525
(912) 590-0973
(912) 590-0180
Mailing address
5191 FIRST COAST TECH PKWY FL 3, JACKSONVILLE, FL 32224-0609
(904) 256-2754
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN258973
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003230782
—
GA
Enumeration date
02/20/2020
Last updated
02/26/2024
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