Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MISS KELLEY MARIE MOODY, NP-C
Active Sole ProprietorMISS KELLEY MARIE MOODY, NP-C is a Adolescent Medicine healthcare provider located in HARTSVILLE, South Carolina. NPI 1194358317 is currently active in the NPPES registry. Verify at CMS.
Adolescent Medicine · HARTSVILLE, SC
Registration Details
- NPI Number
- 1194358317
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Feb 17, 2020 (6.4849010072965 yrs)
- Last Updated
- Feb 8, 2022
- License
-
23682 (SC)
- Sole Proprietor
- Yes
Practice Information
- Address
-
750 W CAROLINA AVEHARTSVILLE, SC, 295504412Browse SC providers · Browse ZIP 29550
- Phone
- 8439519990
- Fax
- 8439519989
- Primary Specialty
-
Adolescent Medicine
207QA0505X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.