Moon, Jennifer Frances

Moon, Jennifer Frances is an individual health care provider with primary practice located at 701 Grove Rd , Greenville SC 29605-4210. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Anesthesiologist Assistant, which is considered as her primary health care specialty. Moon, Jennifer Frances can be contacted via phone (864) 455-3076.

Contact Information

Primary practice address
701 Grove Rd Greenville SC 29605-4210
Phone: (864) 455-3076
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Anesthesiologist Assistant 367H00000X 3 South Carolina

Profile Details

NPI number 1306836986
LBN Legal business name Moon, Jennifer Frances
Credentials AA-C
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 25th, 2005
Last updated Jan 13th, 2022 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1306836986 NPPES
South Carolina MEDICAID AA0002
South Carolina Other C0650

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