Provider / Organization | NPI | Date Certified |
---|---|---|
HIDI H MCCHESNEY MOODY | 1194482489 | 2021-11-21 |
Hidi H Mcchesney Moody is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1194482489. Registration indicates Hidi H Mcchesney Moody is a provider of services with a specialization in Nursing Service Providers, Registered Nurse (Registered Nurse, ) (All Other Specialties & Provider Types, ) (Registered Nurse, Nursing Service Providers) Access to Mental Health/Behavioral Health Providers (Physician Assistants & Advanced Practice Nursing Providers, Nurse Practitioner) (Physician Assistants & Advanced Practice Nursing Providers, Nurse Practitioner) (Nurse Practitioner: Psych/Mental Health, ) (All Other Specialties & Provider Types, ) (Nurse Practitioner Psych/Mental Health, Physician Assistants & Advanced Practice Nursing Providers) (Nurse Practitioner, )
Entity Type | Individual |
Provider Name | Hidi H Mcchesney Moody APRN |
Practice Office Address | 820 PRUDENTIAL DR STE 510 JACKSONVILLE, FL US |
Practice Office Telephone | 9043763800 |
Practice Office Fax | 9043968971 |
Mailing Address | PO BOX 748519 ATLANTA, GA 303748519 US |
Business Telephone | 9043763800 |
Business Fax | 9043763998 |
Address | City / State | Phone / Fax |
---|---|---|
700 Prudential Drive PICU | Jacksonville, FL 32207 | 9049624438 |
836 Prudential Dr Ste 1507 | Jacksonville, FL 322078334 | 9043763800 |
Code | Practice | License No State |
---|---|---|
163W00000X | Nursing Service Providers Registered Nurse Registered Nurse All Other Specialties & Provider Types Registered Nurse Nursing Service Providers | RN9332252
FL |
363LP0808X PRIMARY | Access to Mental Health/Behavioral Health Providers Physician Assistants & Advanced Practice Nursing Providers Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers Nurse Practitioner Nurse Practitioner: Psych/Mental Health All Other Specialties & Provider Types Nurse Practitioner Psych/Mental Health Physician Assistants & Advanced Practice Nursing Providers Nurse Practitioner | APRN11018400
FL |
113756600 | MEDICAID | FL |