Provider Demographics
NPI:1609087048
Name:MOYE, JENNIFER LYNN (APRN)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:LYNN
Last Name:MOYE
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:LYNN
Other - Last Name:MOORE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP
Mailing Address - Street 1:600 PETER JEFFERSON PKWY STE 230
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22911-8835
Mailing Address - Country:US
Mailing Address - Phone:434-984-2400
Mailing Address - Fax:434-984-1147
Practice Address - Street 1:600 PETER JEFFERSON PKWY STE 230
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22911-8835
Practice Address - Country:US
Practice Address - Phone:434-984-2400
Practice Address - Fax:434-984-1147
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-25
Last Update Date:2024-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN2830922363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL012344500Medicaid