Individual
MS. ANNIE R. MOON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
OFF HWY 191 HOSPITAL ROAD, CHINLE, AZ 86503
(928) 674-7001
(928) 674-7705
Mailing address
PO DRAWER PH, CHINLE, AZ 86503
(928) 674-7001
(928) 674-7705
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AP1827
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
956451
—
AZ
Enumeration date
02/26/2007
Last updated
07/27/2016
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