| Doctor Name: | MRS. COURTNEY F MOBERLEY |
| NPI Number: | 1164406567 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | NP-C |
| License Number: | AP04825 |
| Business Practice Address: | 808 Johnson Street Tallulah, LA - 712824535 |
| Business Phone Number: | 3185745080 |
| Business Fax Number: | 3185745052 |
| Mailing Address: | 808 Johnson Street, TALLULAH |
| State: | LA |
| Postal Code: | 712824535 |
| Phone Number: | 3185745080 |
| Fax Number: | 3185745052 |
| NPI Enumeration Date: | 11/30/2005 |
| NPI Last Update Date: | 11/23/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | AP04825 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | LA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |