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Individual

MRS. MARY (MOLLY) MCCAFFERY MOORE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP-BC

Contact information

Practice address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 984-6270
Mailing address
2500 N STATE ST, SCHOOL OF NURSING, JACKSON, MS 39216-4500
(601) 984-6200
(601) 984-6214

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R843526
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00120621
MS
01
7206004
AETNA
MS
01
753068151
MS PHYSICIANS CARE NETWOR
MS
01
753068151001
TRICARE
MS
Enumeration date
03/14/2006
Last updated
05/07/2015
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