Individual
MRS. SANDRA MARIE MOONEY
Active
Sole proprietor
Provider details
NPI number
Gender
F
Contact information
Practice address
11065 LITTLE PATUXENT PKWY, COLUMBIA, MD 21044-2998
(410) 730-5700
(410) 964-3231
Mailing address
7925 ANFRED DR, LAUREL, MD 20723-1136
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
R03707
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
R030707
RN
MD
Enumeration date
10/24/2005
Last updated
07/08/2007
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