NPI age
5 years
Enumerated 2020-07-24
● Active
Type 1 · Individual
Jacqueline H Moder
Moder is 1 of 28 nurse practitioner providers in Waycross and 1 of 3206 in Georgia.
Primary specialty
Nurse Practitioner
Plus 1 subspecialty
Licensed in
GA, FL
2 states
Status
Active
No deactivations on record
Last NPPES update
2020-07-24
Source: monthly bulk 2026-05
Sole proprietor
No
May be part of a larger org
How this provider compares
Across 3206 active nurse practitioner providers in Georgia.
NPI age
5 years
↓ 3 yr below median (8 yr)
State licenses
2 states
Top 91% — 8% of peers are multi-state
Subspecialties
0
30% of peers hold subspecialties
NPI lifetime · 2020 → 2026
2020-07Enumerated in NPPES
2020
2026
Where they practice
Practice location
1912 Memorial Dr Ste E
Waycross, GA 315010989
Mailing address
6115 Cottonwood Ln
Blackshear, GA 315165992
Specialties
-
Nurse Practitioner Primary(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum...
Practice context
Part of a multi-provider practice. 2 other active providers share this practice address in NPPES.
Recently enumerated nearby: 1 new nurse practitioner provider has been added in Waycross in the last 180 days.
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Request a quote →How to verify this provider
- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
- Check the state license is currently active.State licensing boards publish current status; NPPES does not.
- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.