Provider Demographics
NPI:1194282491
Name:SELLERS-MOONEY, DEBORAH CLAY (FNP-BC)
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:CLAY
Last Name:SELLERS-MOONEY
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3651 WINFIELD DUNN PKWY
Mailing Address - Street 2:
Mailing Address - City:KODAK
Mailing Address - State:TN
Mailing Address - Zip Code:37764-1471
Mailing Address - Country:US
Mailing Address - Phone:865-465-7088
Mailing Address - Fax:888-909-9643
Practice Address - Street 1:3651 WINFIELD DUNN PKWY
Practice Address - Street 2:
Practice Address - City:KODAK
Practice Address - State:TN
Practice Address - Zip Code:37764-1471
Practice Address - Country:US
Practice Address - Phone:865-465-7088
Practice Address - Fax:888-909-9643
Is Sole Proprietor?:No
Enumeration Date:2019-02-23
Last Update Date:2019-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN25498363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily