Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Katlyn Nicole Moore

Individual provider Acute Care Nurse Practitioner · NPI 1083591176

Katlyn Nicole Moore is a Nurse Practitioner in Valdosta, Georgia. Qualified in 2025, 1 year ago. Practices with Sgmc Physician Network Inc, a 127-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Georgia.

Years since qualifying
1
Licensed in
GA
In the registry since
2025

Practice location Address checks out

2501 N Patterson St
Valdosta, GA 31602-1735
Phone: (229) 433-1000
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 2409 N Patterson St Ste 340c, Valdosta, GA 31602-2512 — (229) 433-6400

Specialties & licences

Acute Care Nurse Practitioner (primary) Taxonomy 363LA2100X · Licence APRN-NP281867 (GA)

Record details

NPI number1083591176
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedAugust 19, 2025
Last updated in NPPESFebruary 11, 2026
Certification dateFebruary 11, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Group practice Sgmc Physician Network Inc — 127 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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