Jennifer Frances Moynihan, FNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

267970 Issued in AZ

Practice address

406 E Hackamore St
Mesa, AZ 85203-3661

Phone

(602) 376-9155

NPI assigned

Mar 11, 2022

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1646956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646956800000",
    "number": "1154079960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "406 E HACKAMORE ST",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852033661",
            "telephone_number": "602-376-9155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "406 E HACKAMORE ST",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852033661",
            "telephone_number": "602-376-9155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOYNIHAN",
        "first_name": "JENNIFER",
        "middle_name": "FRANCES",
        "name_prefix": "Ms.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-11",
        "last_updated": "2022-03-11",
        "certification_date": "2022-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WW0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Wound Care",
            "state": "AZ",
            "license": "RN159116",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AZ",
            "license": "267970",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mountainside Fitness Acquisitions, LLC
• Jamal Mourad, DO
• Move 2 Action Behavioral Health Solutions LLC
• Move Rehab, LLC
• Travis Mowery, NMD / ND
• MRSC Az Mesa Master Tenant, LLC
• MRSC Az Mesa Master Tenant, LLC
• MRT Transportation LLC
• Ms Wound Care PC
• Edith Wakasa Msafiri, LAAC

• Nurse Practitioner in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.