Moon, Madge Evans

Moon, Madge Evans is an individual health care provider with primary practice located at 3000 Hospital Blvd , Roswell GA 30076-4915. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as her primary health care specialty. Moon, Madge Evans can be contacted via phone (770) 751-2623.

Contact Information

Primary practice address
3000 Hospital Blvd Roswell GA 30076-4915
Phone: (770) 751-2623
Fax: (770) 751-2627
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X RN153489 Georgia
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X APN1305 South Carolina

Profile Details

NPI number 1215917976
LBN Legal business name Moon, Madge Evans
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 19th, 2006
Last updated Jan 21st, 2020 - about 4 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 1215917976 NPPES
Georgia MEDICAID 000924712D
Georgia MEDICAID 000924712E

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