Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LA2200X | Nurse Practitioner - Adult Health | 000022516 | TN |
N | 363LG0600X | Nurse Practitioner - Gerontology | 000022516 | TN |
Y | 363LP2300X | Nurse Practitioner - Primary Care | 000022516 | TN |
NPI | 1013443886 |
---|---|
Provider Name | Debra Ann Moroney |
First Address | Sevierville, TN 37876-7911 |
Second Address | Knoxville, TN 37920-1545 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/05/2017 |
Last Update Date | 01/11/2019 |