Individual
ATHENA MOON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
3001 W UNIVERSITY BLVD, ODESSA, TX 79764-7129
(432) 580-5966
Mailing address
3001 W UNIVERSITY BLVD, ODESSA, TX 79764-7129
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP131550
TX
Other
Enumeration date
08/01/2016
Last updated
08/01/2016
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