Brad Alan Moon CRNA

NPI 1093991358 - Nurse Anesthetist, Certified Registered - 367500000X

NPI Details
NPI 1093991358
Gender Male
Enumeration Date 01/17/2008
Last Updated 05/16/2016
Entity Type Individual
Active Over 8 years ago
Practice Location
950 W PINON ST
FARMINGTON NM, 87401-5905, US
Phone (505) 564-8200
Fax
Business Location
950 W PINON ST
FARMINGTON NM, 87401-5905, US
Phone (505) 564-8200
Fax
Toxanomy
Taxonomy Code 367500000X
License State New Mexico
License Number R63204
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According to our database, Brad Alan Moon CRNA NPI is 1093991358, taxonomy code is 367500000X and license number is R63204, license state is located at New Mexico. Brad Alan Moon CRNA physically located at 950 W Pinon St, Farmington NM, 87401-5905. NPI Number Brad Alan Moon CRNA has the Individual type.

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1093991358 NPI number is provided on an as is basis without warranty of any kind. 1093991358 is maintained by the National Plan & Provider Enumeration System. The contents of Brad Alan Moon CRNA are for informational purposes only.