Individual
SUSANNA MOBERLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
459 KEENE CENTRE DR, NICHOLASVILLE, KY 40356-1492
(859) 241-1136
(859) 241-1009
Mailing address
459 KEENE CENTRE DR, NICHOLASVILLE, KY 40356-1492
(859) 241-1136
(859) 241-1009
Taxonomy
Speciality
Code
Description
License number
State
207RR0500X
Rheumatology Physician
Primary
3009443
KY
363L00000X
Nurse Practitioner
3009443
KY
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
3009443
KY
363LW0102X
Women's Health Nurse Practitioner
3009443
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1346035524
—
KY
05
—
1568843316
—
KY
Enumeration date
06/17/2015
Last updated
12/10/2025
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