Individual
JASON MOYNS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
560 W MITCHELL ST STE 560, PETOSKEY, MI 49770-2279
(231) 487-5400
Mailing address
560 W MITCHELL ST STE 560, PETOSKEY, MI 49770-2279
(231) 487-5400
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4704250400
MI
363LA2200X
Adult Health Nurse Practitioner
209013187
IL
363LA2200X
Adult Health Nurse Practitioner
209013187I
IL
Other
Enumeration date
08/24/2015
Last updated
02/03/2021
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