Individual
MR. ERIC TYSON MOON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1805 27TH ST, PORTSMOUTH, OH 45662-2640
(740) 356-8034
(740) 353-7900
Mailing address
1735 27TH STREET, WALLER BLDG SUITE B06, PORTSMOUTH, OH 45662-0000
(740) 356-8034
(740) 353-7900
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN.312401
OH
163W00000X
Registered Nurse
RN593747
PA
363L00000X
Nurse Practitioner
ARNP9266653
FL
367500000X
Certified Registered Nurse Anesthetist
101896
FL
367500000X
Certified Registered Nurse Anesthetist
Primary
RN593747
PA
Other
Enumeration date
04/15/2014
Last updated
06/22/2018
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