Heather Moya, APRN, CPNP

Individual provider Active NPI Pediatric Nurse Practitioner · Springfield, LA

NPI 1306236377 · NPPES record last updated Apr 1, 2019

Key facts

NPI
1306236377
Entity type
Individual (NPI type 1)
Primary specialty
Pediatric Nurse Practitioner 363LP0200X
License
AP08164 (LA)
Practice address
27124 Highway 42
Springfield, LA 70462
Phone
(225) 683-5292
Fax
(225) 683-1310
NPI assigned
Jan 29, 2015
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Certified Pediatric Nurse Practitioner, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP08164LAMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Children'S International L.L.C. Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X AP08164 LA Yes

Addresses

Primary practice location

27124 Highway 42
Springfield, LA 70462

Mailing address

106 Mimosa St
Amite, LA 70422-2136
Phone (985) 247-2411

Other practice location 1

106 Mimosa St
Amite, LA 70422-2136
Phone (985) 247-2411

Other identifiers

IdentifierTypeStateIssuer
2382217MedicaidLA

Other providers in Springfield, LA

All providers in Springfield, LA · Pediatric Nurse Practitioner in Louisiana

Sources for this page

Verify at the official NPI Registry.