| Doctor Name: | HOLLY LYNN MOEN |
| NPI Number: | 1306994769 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | CNM |
| License Number: | 285953 |
| Business Practice Address: | 23 Main St Winters, CA - 956941722 |
| Business Phone Number: | 5302121028 |
| Business Fax Number: | |
| Mailing Address: | 2301 Bryce Ln, DAVIS |
| State: | CA |
| Postal Code: | 956166608 |
| Phone Number: | 5307583459 |
| Fax Number: | |
| NPI Enumeration Date: | 01/08/2007 |
| NPI Last Update Date: | 03/07/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WX0002X |
| License Number: | 285953 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | CA |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Obstetric, High-Risk |
| Taxonomy Definition: | |