Provider Demographics
NPI:1134242456
Name:MOYNIHAN, DEBRA ANN (APN-C)
Entity type:Individual
Prefix:MRS
First Name:DEBRA
Middle Name:ANN
Last Name:MOYNIHAN
Suffix:
Gender:F
Credentials:APN-C
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 3440
Mailing Address - Street 2:
Mailing Address - City:MURRELLS INLET
Mailing Address - State:SC
Mailing Address - Zip Code:29576-2674
Mailing Address - Country:US
Mailing Address - Phone:843-651-6525
Mailing Address - Fax:843-357-5035
Practice Address - Street 1:4017 BYPASS 17
Practice Address - Street 2:
Practice Address - City:MURRELLS INLET
Practice Address - State:SC
Practice Address - Zip Code:29576-2674
Practice Address - Country:US
Practice Address - Phone:843-651-6525
Practice Address - Fax:843-357-5035
Is Sole Proprietor?:No
Enumeration Date:2007-04-10
Last Update Date:2012-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3398363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology