Individual
TERESA MOONEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
324 LESLIE CT, BRISTOL, TN 37620
(423) 646-2864
Mailing address
310 MARYLAND AVE, BECKLEY, WV 25801-4226
(304) 228-9158
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
APRN82500-NP-C
WV
Other
Enumeration date
08/17/2018
Last updated
12/24/2018
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