Provider Demographics
NPI:1902630601
Name:MOYER, EDWARD JOSEPH JR (FNP-C)
Entity type:Individual
Prefix:
First Name:EDWARD
Middle Name:JOSEPH
Last Name:MOYER
Suffix:JR
Gender:M
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:847 EASTON RD STE 2500
Mailing Address - Street 2:
Mailing Address - City:WARRINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:18976-2907
Mailing Address - Country:US
Mailing Address - Phone:215-918-5555
Mailing Address - Fax:
Practice Address - Street 1:847 EASTON RD STE 2500
Practice Address - Street 2:
Practice Address - City:WARRINGTON
Practice Address - State:PA
Practice Address - Zip Code:18976-2907
Practice Address - Country:US
Practice Address - Phone:215-918-5555
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-27
Last Update Date:2024-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP030513363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily