Individual
MISS MCKENNA ELYSE MOE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
1955 TEXTILE WAY STE B, GAINESVILLE, GA 30501-2543
(678) 987-1499
(678) 987-1498
Mailing address
1955 TEXTILE WAY STE B, GAINESVILLE, GA 30501-2543
(678) 987-1499
(678) 987-1498
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10350
GA
Other
Enumeration date
07/21/2021
Last updated
07/21/2021
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