Individual
ELAINE MARIE NEW MOON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
4520 N CENTRAL AVE STE 130, WILCOX SUMMER HAWK RANCH, PHOENIX, AZ 85012-1804
(602) 424-1600
(602) 532-7202
Mailing address
4520 N CENTRAL #130, WILCOX SUMMER HAWK RANCH, PHOENIX, AZ 85012
(602) 424-1600
(602) 532-7202
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN064934
AZ
Other
Enumeration date
04/17/2007
Last updated
05/18/2009
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