Individual
JEFFERY H MOONEYHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNP
Contact information
Practice address
4350 CLEVELAND AVE, ALTOONA, AL 35952
(205) 589-6361
Mailing address
206 OHARA DR, ALBERTVILLE, AL 35950-2596
(256) 243-2430
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
1-109518
AL
363LF0000X
Family Nurse Practitioner
Primary
1109518
AL
Other
Enumeration date
06/28/2016
Last updated
09/15/2023
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