Provider Demographics
NPI:1568757540
Name:MOODY, RASHAUNA GUILLORY (ANP-BC)
Entity Type:Individual
Prefix:MRS
First Name:RASHAUNA
Middle Name:GUILLORY
Last Name:MOODY
Suffix:
Gender:F
Credentials:ANP-BC
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 1152
Mailing Address - Street 2:
Mailing Address - City:VILLE PLATTE
Mailing Address - State:LA
Mailing Address - Zip Code:70586-1152
Mailing Address - Country:US
Mailing Address - Phone:337-459-6933
Mailing Address - Fax:337-266-8463
Practice Address - Street 1:2495 SHREVEPORT HWY
Practice Address - Street 2:
Practice Address - City:PINEVILLE
Practice Address - State:LA
Practice Address - Zip Code:71360-4044
Practice Address - Country:US
Practice Address - Phone:337-459-6933
Practice Address - Fax:337-266-8463
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-17
Last Update Date:2023-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP06458363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health