Provider Demographics
NPI:1114202462
Name:MOYER, CHRISTA L (NP-C)
Entity Type:Individual
Prefix:
First Name:CHRISTA
Middle Name:L
Last Name:MOYER
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 S SUNSET AVE
Mailing Address - Street 2:
Mailing Address - City:LITTLEFIELD
Mailing Address - State:TX
Mailing Address - Zip Code:79339-4810
Mailing Address - Country:US
Mailing Address - Phone:806-285-2633
Mailing Address - Fax:806-743-9363
Practice Address - Street 1:524 E. 8TH
Practice Address - Street 2:
Practice Address - City:OLTON
Practice Address - State:TX
Practice Address - Zip Code:79064
Practice Address - Country:US
Practice Address - Phone:806-285-2633
Practice Address - Fax:806-285-3312
Is Sole Proprietor?:No
Enumeration Date:2011-10-19
Last Update Date:2018-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX721574363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX721574OtherLICENSE