Individual
EDITH MOON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
306 SAN PABLO ST SE, ALBUQUERQUE, NM 87108-3167
(505) 272-9242
Mailing address
306 SAN PABLO ST SE, ALBUQUERQUE, NM 87108-3167
(505) 272-9242
(505) 272-1538
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
57399
NM
Other
Enumeration date
08/22/2019
Last updated
06/08/2023
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