Provider Demographics
NPI:1275148561
Name:MOYER, SUZANNE D (DNP, AG-ACNP, APRN)
Entity Type:Individual
Prefix:DR
First Name:SUZANNE
Middle Name:D
Last Name:MOYER
Suffix:
Gender:F
Credentials:DNP, AG-ACNP, APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1000, DEPT 960
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38148-0001
Mailing Address - Country:US
Mailing Address - Phone:019-758-9900
Mailing Address - Fax:901-752-2335
Practice Address - Street 1:1325 EASTMORELAND AVE STE 365
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38104-7542
Practice Address - Country:US
Practice Address - Phone:901-272-6030
Practice Address - Fax:901-516-8450
Is Sole Proprietor?:No
Enumeration Date:2020-09-13
Last Update Date:2022-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN28117363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care