| Doctor Name: | MRS. BROOKE SHOEMAKER MOODY |
| NPI Number: | 1154608859 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | CRNP |
| License Number: | 1-116290 |
| Business Practice Address: | 21680 Al Highway 79 Scottsboro, AL - 357685904 |
| Business Phone Number: | 2565873050 |
| Business Fax Number: | |
| Mailing Address: | 21680 Al Highway 79, SCOTTSBORO |
| State: | AL |
| Postal Code: | 357685904 |
| Phone Number: | 2565873050 |
| Fax Number: | |
| NPI Enumeration Date: | 11/08/2011 |
| NPI Last Update Date: | 10/18/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 1-116290 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AL |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |