Individual
MS. MARY THURSTON MOYNAHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP, BC
Contact information
Practice address
109 EXETER STREET, MANTEO, NC 27954-1000
(252) 475-5007
Mailing address
189 HIGH DUNE LOOP, KITTY HAWK, NC 27949-3710
(252) 261-1222
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
201043
NC
Other
Enumeration date
03/27/2007
Last updated
07/08/2007
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