Provider Demographics
NPI:1730858226
Name:MOODY, WHITNEY (NP)
Entity type:Individual
Prefix:
First Name:WHITNEY
Middle Name:
Last Name:MOODY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:880 UPPER GLADY FORK RD
Mailing Address - Street 2:
Mailing Address - City:CANDLER
Mailing Address - State:NC
Mailing Address - Zip Code:28715-9145
Mailing Address - Country:US
Mailing Address - Phone:828-337-4271
Mailing Address - Fax:
Practice Address - Street 1:1510 HEBRON RD
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28739-4794
Practice Address - Country:US
Practice Address - Phone:828-693-8461
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-08
Last Update Date:2021-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCMOOD-KCJ61363LF0000X
NC5015013363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily