Caryl Jean Moulder, RN

Primary specialty

Case Management Registered NurseTaxonomy code 163WC0400X

License

R869685 Issued in MS

Practice address

5503 Marvin Shields Blvd
Gulfport, MS 39501-9007

Phone

(228) 326-3031

NPI assigned

Dec 12, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1197417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1197417600000",
    "number": "1730362872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5503 MARVIN SHIELDS BLVD",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395019007",
            "telephone_number": "228-326-3031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5503 MARVIN SHIELDS BLVD",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395019007",
            "telephone_number": "228-326-3031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOULDER",
        "first_name": "CARYL",
        "middle_name": "JEAN",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-12-12",
        "last_updated": "2007-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Case Management",
            "state": "MS",
            "license": "R869685",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Case Management Registered Nurse in Gulfport, MS
• Providers in Gulfport, MS by specialty
• Case Management Registered Nurse in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2007; 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.