| Doctor Name: | MAREN K MOODY |
| NPI Number: | 1073765277 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | 013032565012 |
| Business Practice Address: | 208 Marc Wagner Drive Victoria, KS - 67671 |
| Business Phone Number: | 7877352627 |
| Business Fax Number: | |
| Mailing Address: | 1337 Grand St, HAYS |
| State: | KS |
| Postal Code: | 676019219 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 10/21/2008 |
| NPI Last Update Date: | 10/21/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LN0000X |
| License Number: | 013032565012 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | KS |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Neonatal |
| Taxonomy Definition: | |