# MOONEYHAM PROPERTIES

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- **Entity:** Organization
- **Status:** Active
- **Other names:** 4 the Family Healthcare
- **Organization subpart:** No

## Provider details

- **NPI number:** 1184913014
- **Authorized official:** MRS. JENNIFER WEDGEWORTH MOONEYHAM FNP-BC (PROVIDER/OWNER)
- **Authorized official phone:** (601) 214-4420

## Contact information

- **Practice address:** 1127 OLD FANNIN RD, C, BRANDON, MS 39047-9265
- **Practice address phone:** (601) 214-4420
- **Mailing address:** 1127 OLD FANNIN RD, C, BRANDON, MS 39047-9265
- **Mailing address phone:** (601) 214-4420

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261Q00000X | Clinic/Center | MS845026 | MS | Yes |

## Other

- **Enumeration date:** 03/31/2011
- **Last updated:** 03/31/2011