National Provider Identifier

Mallory A Moebs, NP

Mallory A Moebs, NP is listed in the NPPES registry with a primary specialty of Family Nurse Practitioner in Orchard Park, NY and a listed phone number of (716) 674-3104.

NPI 1376320390Orchard Park, NYFamily Nurse Practitioner

Profile Overview

NPI
1376320390
Provider Type
Individual
Primary Specialty
Family Nurse Practitioner
Enumeration Date
September 12, 2023
Last Updated
April 25, 2024

Practice Location

  • 3401 Orchard Park RD Ste C
  • Orchard Park, NY 14067-9274

Phone: (716) 674-3104

Mailing Address

  • 8276 Mill RD
  • Gasport, NY 14067-9274

Specialties

  • Family Nurse Practitioner (363LF0000X)
Full Record
NPI
1376320390
Entity Type
Individual
Last Name
Moebs
First Name
Mallory
Middle Name
A
Credential
NP
Mailing Street Address
8276 Mill RD
Mailing City
Gasport
Mailing State
NY
Mailing ZIP Code
14067-9274
Mailing Country
US
Mailing Phone
(716) 417-6564
Practice Street Address
3401 Orchard Park RD Ste C
Practice City
Orchard Park
Practice State
NY
Practice ZIP Code
14067-9274
Practice Country
US
Practice Phone
(716) 674-3104
Practice Fax
(716) 674-0666
Enumeration Date
September 12, 2023
Last Updated
April 25, 2024
Sex
Female
Sole Proprietor
No
Certification Date
September 12, 2023
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Family Nurse Practitioner (363LF0000X)