Individual
MRS. FAWNE MOON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
50 ESSEX STREET, YOUNGSTOWN, OH 44502
(330) 746-2240
Mailing address
3754 BAYMAR DRIVE, YOUNGSTOWN, OH 44511
(330) 402-4670
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN-102367
OH
Other
Enumeration date
12/19/2014
Last updated
12/19/2014
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