Provider Demographics
NPI:1184067845
Name:MOEHRING, JODY MARIE (ANP-BC)
Entity type:Individual
Prefix:
First Name:JODY
Middle Name:MARIE
Last Name:MOEHRING
Suffix:
Gender:F
Credentials:ANP-BC
Other - Prefix:
Other - First Name:JODY
Other - Middle Name:MARIE
Other - Last Name:MANTERHACH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2266 POINTE PL
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45244-2998
Mailing Address - Country:US
Mailing Address - Phone:713-294-4786
Mailing Address - Fax:
Practice Address - Street 1:4777 E GALBRAITH RD STE 310
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45236-2725
Practice Address - Country:US
Practice Address - Phone:513-686-5250
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-12
Last Update Date:2025-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX726826363L00000X
OHAPRN.CNP.019351363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8813NAOtherBCBS
TX318517501Medicaid
TX282817YKQHMedicare PIN