Theresa E Moff, CRNP
Nurse Practitioner, Pediatrics in Williamsport, PA. Individual provider (NPI-1).
NPI number1457566176
StatusActive
Last updated in NPPESJun 4, 2014
Details
- NPI
- 1457566176
- Entity type
- Individual (NPI-1)
- Name
- Theresa E Moff
- Credential
- CRNP
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- May 14, 2007
- Last updated
- Jun 4, 2014
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LP0200X | Nurse Practitioner, Pediatrics | VP001426D | PA | Yes |
| 163W00000X | Registered Nurse | RN269878L | PA |
Practice location
700 High StWilliamsport, PA 17701-3198
Phone 570-321-2810 · Fax 570-321-2811
Mailing address
1201 Grampian BlvdSuite 1k
Williamsport, PA 17701-1900
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