Individual
FALLON MOODY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
305 W COUNTRY CLUB RD, ROSWELL, NM 88201-5892
(575) 622-6322
(575) 622-6888
Mailing address
PO BOX 2608, ROSWELL, NM 88202-2608
(575) 622-6322
(575) 622-6888
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
56553
NM
Other
Enumeration date
05/07/2025
Last updated
05/07/2025
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