Individual
KATIE LYNN MOODY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
100 E LANCASTER AVE, CTICU 2ND FLOOR HEART PAVILION, WYNNEWOOD, PA 19096-3450
(484) 476-1000
(484) 476-5931
Mailing address
3803 W CHESTER PIKE STE 160, NEWTOWN SQUARE, PA 19073-2336
(484) 476-1000
(484) 476-5931
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
SP021337
PA
Other
Enumeration date
01/17/2020
Last updated
02/07/2026
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