Doctor Name: | ASHLEY MARIE MOON |
NPI Number: | 1053566687 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PA-C |
License Number: | MA053413 |
Business Practice Address: | 1205 River Ave 1st Floor Williamsport, PA - 177013724 |
Business Phone Number: | 5703235991 |
Business Fax Number: | 5703236578 |
Mailing Address: | 7 Dock Hill Rd, MIDDLEBURG |
State: | PA |
Postal Code: | 178428910 |
Phone Number: | 5708372123 |
Fax Number: | 5708372185 |
NPI Enumeration Date: | 11/24/2008 |
NPI Last Update Date: | 01/18/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | MA053413 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |