| Doctor Name: | MRS. KATHY GRAY MOOCK |
| NPI Number: | 1073958971 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | R.N. |
| License Number: | 24570 |
| Business Practice Address: | 1518 Main Rd St John's High School Johns Island, SC - 294553437 |
| Business Phone Number: | 8435596400 |
| Business Fax Number: | 8435596207 |
| Mailing Address: | 1518 Main Rd, St John's High School JOHNS ISLAND |
| State: | SC |
| Postal Code: | 294553437 |
| Phone Number: | 8435596400 |
| Fax Number: | 8435596207 |
| NPI Enumeration Date: | 05/06/2013 |
| NPI Last Update Date: | 05/06/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WS0200X |
| License Number: | 24570 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | SC |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | School |
| Taxonomy Definition: | |