National Provider Identifier Database

FALLON MOODY, FNP – NPI #1740070358
Primary Care


Contact Information

FALLON MOODY, FNP
305 W COUNTRY CLUB RD
ROSWELL, NM88201-5892
Phone: 575-622-6322
Fax: 575-622-6888
Website:
Specialty Taxonomy Code
* Primary Care 363LP2300X

* Indicates primary specialty

NPI Profile & details for FALLON MOODY

NPI Number 1740070358
Credentials FNP (Family Nurse Practitioner)
Entity Individual
Enumeration date 05/07/2025
Last updated 05/07/2025 - More than a year ago
Sole proprietor1 No
Identifiers
  • NM License #: 56553
Hospital affiliation n/a

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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