| Doctor Name: | MRS. BRENDA B MOELLER |
| NPI Number: | 1083896104 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RN |
| License Number: | RN050773 |
| Business Practice Address: | 460 S 7th St Coolidge, AZ - 852284603 |
| Business Phone Number: | 5207232706 |
| Business Fax Number: | 5207232707 |
| Mailing Address: | 460 S 7th St, COOLIDGE |
| State: | AZ |
| Postal Code: | 852284603 |
| Phone Number: | 5207232706 |
| Fax Number: | 5207232707 |
| NPI Enumeration Date: | 11/30/2007 |
| NPI Last Update Date: | 11/30/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WS0200X |
| License Number: | RN050773 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AZ |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | School |
| Taxonomy Definition: | |