Doctor Name: | SANDRA MOYLE |
NPI Number: | 1194860833 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | RN |
License Number: | RN041961 |
Business Practice Address: | 8766 East Hwy 69 Humboldt Unified Scool District #22 Special Services Of Prescott Valley, AZ - 86314 |
Business Phone Number: | 9287594028 |
Business Fax Number: | 9287594030 |
Mailing Address: | 4957 E North Star Mine Rd, PRESCOTT |
State: | AZ |
Postal Code: | 86303 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 02/20/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 163WS0200X |
License Number: | RN041961 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AZ |
Taxonomy Type: | Nursing Service Providers |
Taxonomy Classification: | Registered Nurse |
Taxonomy Specialization: | School |
Taxonomy Definition: |