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Contact Information

JENNIFER P MOODY, CRNA
2080 W ARLINGTON BLVD STE B
GREENVILLE, NC27834
 Phone: 252-752-2140
 Fax: 252-689-6502
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Nurse Anesthetist, Certified Registered

367500000X 43 Certified Registered Nurse Anesthetist (CRNA)
 

Registered Nurse

163W00000X
Indicates primary specialty

NPI Profile & details for JENNIFER P MOODY · (Female)

NPI Number 1497037147
Status Active
Credentials CRNA (Certified Registered Nurse Anesthetist)
Entity Individual
Enumeration date 09/19/2011
Last updated 08/23/2018 - About 8 years ago
Sole proprietor 1 No
Identifiers
  • NC License # 208971
  • NC License # 88357
  • NC Medicaid 8054065
  • NC Other P01113167 RAILROAD MEDICARE
  • NC Other 1497037147 TRICARE
Hospital affiliation(s)
  • VIDANT MEDICAL CENTER - (Acute Care)
    2100 STANTONSBURG RD
    GREENVILLE, NC 27834
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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