Individual
SAVANNAH VAUGHN MOON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1210 7TH ST S, CLANTON, AL 35045-3724
(334) 514-3848
(334) 280-0625
Mailing address
PO BOX 130, WETUMPKA, AL 36092-0003
(334) 280-0620
(334) 280-0625
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
1-140246
AL
363LP2300X
Primary Care Nurse Practitioner
Primary
1-140246
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
511-91222
BCBS
—
Enumeration date
04/20/2017
Last updated
04/12/2021
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