| Doctor Name: | MS. MARY THURSTON MOYNAHAN |
| NPI Number: | 1962520841 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | FNP, BC |
| License Number: | 201043 |
| Business Practice Address: | 109 Exeter Street Manteo, NC - 279541000 |
| Business Phone Number: | 2524755007 |
| Business Fax Number: | |
| Mailing Address: | 189 High Dune Loop, KITTY HAWK |
| State: | NC |
| Postal Code: | 279493710 |
| Phone Number: | 2522611222 |
| Fax Number: | |
| NPI Enumeration Date: | 03/27/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 201043 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NC |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |