MS. SUSAN MICHELLE MOULTRIE NURSE PRACTITIONER
NPI 1629352901
Nurse Practitioner - Family in Victorville, CA

Q: What is Susan Moultrie's NPI number?

The NPI number for Susan Moultrie is 1629352901. It was assigned to this individual provider in the NPPES registry on October 4, 2011. The provider is also known as Ms. Susan Michelle Moultrie Nurse Practitioner.

Q: What is Susan Moultrie's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Q: When was this NPI record last updated?

The NPPES record for Susan Moultrie was last updated on October 31, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 21 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since October 04, 2011

12830 HESPERIA RD STE CDE, VICTORVILLE, CA 92395(760) 684-8999(760) 684-8111 Get Directions Write a Review

NPPES record last updated: October 31, 2024. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Ms. Susan Michelle Moultrie Nurse Practitioner NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MS. SUSAN MICHELLE MOULTRIE NURSE PRACTITIONER (NPI 1629352901) is an individual family provider in Victorville, California, licensed in California (12560) and active in the NPI registry since October 2011.

NPPES Registry Identity

NPI1629352901

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameMS. SUSAN MICHELLE MOULTRIECredential: NURSE PRACTITIONER

Location Address12830 HESPERIA RD STE CDEVictorville, CA 92395-7788

Mailing Address4800 Citrus Ave, Apt 5104Fontana, CA 92336 · (770) 712-3049

Phone(760) 684-8999

Fax(760) 684-8111

Sole ProprietorYes

Enumeration DateOctober 4, 2011

Last NPPES UpdateOctober 31, 2024

NPPES CertifiedOctober 25, 2024

✔ NPI 1629352901 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

License✔ Licensed in CA · 12560

12830 HESPERIA RD STE CDE, Victorville, CA 92395

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Other Names 1

Former Name (1)Ms. Susan Michelle Moultrie Nurse Practitioner

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Susan Moultrie's NPI number?

The NPI number for Susan Moultrie is 1629352901. It was assigned to this individual provider in the NPPES registry on October 4, 2011. The provider is also known as Ms. Susan Michelle Moultrie Nurse Practitioner.

Where is Susan Moultrie located?

Susan Moultrie practices at 12830 Hesperia Rd Ste Cde, Victorville, CA 92395. The listed phone number is (760) 684-8999.

What is Susan Moultrie's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

When was this NPI record last updated?

The NPPES record for Susan Moultrie was last updated on October 31, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 21 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.