Vickie Moody, RN BSN

Individual provider Active NPI School Registered Nurse · Clayton, OH

NPI 1669869699 · NPPES record last updated Apr 16, 2015

Key facts

NPI
1669869699
Entity type
Individual (NPI type 1)
Primary specialty
School Registered Nurse 163WS0200X
License
RN210720 (OH)
Practice address
4916 National Rd
Clayton, OH 45315-9714
Phone
(937) 832-6060
Fax
(937) 832-6001
NPI assigned
Apr 16, 2015
Sex
Female
Sole proprietor
Yes

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Bachelor on Science - Nursing, Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN210720OHMDSchool Registered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
School Registered Nurse 163WS0200X RN210720 OH Yes

Addresses

Primary practice location

4916 National Rd
Clayton, OH 45315-9714

Mailing address

1495 W Evanston Rd
Tipp City, OH 45371-2019
Phone (937) 667-0023

Other providers in Clayton, OH

All providers in Clayton, OH · School Registered Nurse in Ohio

Sources for this page

Verify at the official NPI Registry.