NP Shannon L Moffett, NPI 1174606289
Acute Care Nurse Practitioner in Jackson, MS, US

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NPI number: what is it?

The NPI, or National Provider Identifier, is a non-repeatable number for health care providers. The NPI always consists of 10 digits and is used for administrative and financial procedures. The NPI wa...

NPI 1174606289
NPI Entity Type Individual
Provider Name NP Shannon L Moffett
Enumeration Date September 30, 2009
Last Update Date September 30, 2009
Provider Location Address 2500 North State Street, Department Of Medicine Division Of Pulmonary, Jackson, MS, US
Provider Mailing Address 2500 N State St, Division Of Pulmonary, Jackson, MS, US, 392164500
Is Sole Proprietor? No
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Primary Taxonomy

Taxonomy Code

363LA2100X

Taxonomy Name Acute Care Nurse Practitioner
Classification

Nurse Practitioner

Group

Physician Assistants & Advanced Practice Nursing Providers

License No. R857161
License State MS
Description Definition to come...

Business Address

NP Shannon L Moffett
2500 North State Street
Department Of Medicine Division Of Pulmonary

Jackson, MS, US

Phone: 601-984-5650
Fax: 601-984-5658

Mailing Address

NP Shannon L Moffett
2500 N State St
Division Of Pulmonary
Jackson, MS, US
ZIP 392164500
Phone: 601-984-6426
Fax: 601-984-6439

Other Identifiers

Identifier Identifier State Identifier Issuer Type/Code
06188884 MS MEDICAID 05
P01648526 MS RAILROAD MEDICARE PTAN 01

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