| Doctor Name: | MS. BRENDA G MOON |
| NPI Number: | 1205941655 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | C-NP |
| License Number: | 1-066882 |
| Business Practice Address: | 2400 Hospital Rd # 62-221 Tuskegee, AL - 360835001 |
| Business Phone Number: | 3347270550 |
| Business Fax Number: | 3347246858 |
| Mailing Address: | 657 E Thach Ave, AUBURN |
| State: | AL |
| Postal Code: | 368305543 |
| Phone Number: | 3347270550 |
| Fax Number: | 3347246858 |
| NPI Enumeration Date: | 08/19/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 1-066882 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AL |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |