WANDA FAYE MOONEY (NPI# 1316557705) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316557705 |
| Entity Type | Individual |
| Full Name | WANDA FAYE MOONEY |
| Other Name | WANDA FAYE ELLIS |
| Credential | APRN |
| Practice Address |
201 S Bay Dr Bay AR 72411-9482 |
| Mailing Address |
4196 Highway 62 412 Ste A Hardy AR 72542-8002 |
| Practice Telephone | 8707701920 |
| Practice Fax Number | 8709947488 |
| Mailing Fax Number | 8708562107 |
| Enumeration Date | 2020-07-31 |
| Last Update Date | 2020-07-31 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
125714 | AR | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
201 S BAY DR |
| City | BAY |
| State | AR |
| Zip Code | 72411-9482 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871968388 | Bradley Bibb Md Pllc | Family Medicine | 201 S Bay Dr, Bay, AR 72411 | 2015-12-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598810384 | Bay School District 21 | Local Education Agency (LEA) | 700 School Street, Bay, AR 72411 | 2007-01-24 |
| 1649609520 | Hannah Leanne Riggs | Specialist/Technologist | 700 School Street, Bay, AR 72411 | 2013-11-01 |
| 1659702025 | Crissie Parks | Developmental Therapist | 614 N Bay Dr, Bay, AR 72411-9409 | 2013-12-10 |
| 1740622497 | Randi L Davis | Nurse Practitioner | 301 S Bay Dr, Bay, AR 72411-9482 | 2013-07-23 |
| 1497120596 | Phillip Carmer | Physical Therapist | 115 Terra Dr, Bay, AR 72411-9501 | 2015-12-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871968388 | Bradley Bibb Md Pllc | Family Medicine | 201 S Bay Dr, Bay, AR 72411 | 2015-12-09 |
| 1497120596 | Phillip Carmer | Physical Therapist | 115 Terra Dr, Bay, AR 72411-9501 | 2015-12-01 |
| 1659702025 | Crissie Parks | Developmental Therapist | 614 N Bay Dr, Bay, AR 72411-9409 | 2013-12-10 |
| 1598810384 | Bay School District 21 | Local Education Agency (LEA) | 700 School Street, Bay, AR 72411 | 2007-01-24 |
| 1386704419 | Bhaskar Devanagondi | Specialist | 2110 16th St 1, Bay Pediatric Clinic, Bay, MI 48708 | 2006-12-11 |
| 1649609520 | Hannah Leanne Riggs | Specialist/Technologist | 700 School Street, Bay, AR 72411 | 2013-11-01 |
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740622497 | Randi L Davis | Nurse Practitioner | 301 S Bay Dr, Bay, AR 72411-9482 | 2013-07-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023617594 | Mckenzie Lauren Cotton | Nurse Practitioner | 1065 Skyline Dr, Conway, AR 72032-3530 | 2020-10-25 |
| 1437758026 | Ashley Michelle Rima | Nurse Practitioner | 205 Spencer St, Hot Springs, AR 71901-7742 | 2020-10-23 |
| 1063010874 | Phillip Wayne Stokes Jr. | Nurse Practitioner | 31 Ashcraft Ct, Paragould, AR 72450-7592 | 2020-10-14 |
| 1720685308 | Dannie Evenda Loy | Nurse Practitioner | 101 Hammond Drive #2131, Hot Springs, AR 71914 | 2020-10-06 |
| 1457958233 | Kaitlyn Soffray Simmons | Nurse Practitioner | 500 Kitchen St, Jonesboro, AR 72401-3135 | 2020-10-05 |
| 1013524487 | Danielle Lynn Frueh | Nurse Practitioner | 103 W University St, Siloam Springs, AR 72761-2663 | 2020-09-29 |
| 1407463938 | Aleshia Williams | Nurse Practitioner | 5401 Clear Creek Ln, Jonesboro, AR 72404-7006 | 2020-09-29 |
| 1801403217 | Jessica Evelyn Mcnamee | Nurse Practitioner | 180 Medical Park Pl Ste 202, Hot Springs, AR 71901-8067 | 2020-09-29 |
| 1437765831 | Allison Nicole Hitt | Nurse Practitioner | 3644 W Hwy 18, Manila, AR 72442 | 2020-09-21 |
| 1528674181 | Maggie Mullican | Nurse Practitioner | 7084 S Pleasant Ridge Dr, Fayetteville, AR 72704-5447 | 2020-09-18 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.