Individual
DEVI DOVE MOON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
114 N LEHMBERG RD, COLUMBUS, MS 39702-5554
(662) 251-2603
Mailing address
114 N LEHMBERG RD, COLUMBUS, MS 39702-5554
(662) 251-2603
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
904108
MS
Other
Enumeration date
08/27/2020
Last updated
08/27/2020
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