Provider Demographics
NPI:1801033733
Name:NDUATI-MOODY, VIVIENNE NYAMBURA (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:VIVIENNE
Middle Name:NYAMBURA
Last Name:NDUATI-MOODY
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Gender:F
Credentials:PA-C
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Mailing Address - Street 1:550 PEACHTREE ST NE
Mailing Address - Street 2:SUITE 1600
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30308-2247
Mailing Address - Country:US
Mailing Address - Phone:404-881-1094
Mailing Address - Fax:404-885-7777
Practice Address - Street 1:340 BOULEVARD NE
Practice Address - Street 2:SUITE 145
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30312-1273
Practice Address - Country:US
Practice Address - Phone:404-584-7306
Practice Address - Fax:404-584-7308
Is Sole Proprietor?:No
Enumeration Date:2009-01-14
Last Update Date:2013-09-13
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant