Doctor Name: | HEATHER DENISE MOEHN |
NPI Number: | 1255669677 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | RN |
License Number: | 110625 |
Business Practice Address: | 208 Bank St Keokuk, IA - 526325819 |
Business Phone Number: | 3195243873 |
Business Fax Number: | 3195243876 |
Mailing Address: | 2323 Windish Dr, GALESBURG |
State: | IL |
Postal Code: | 614019780 |
Phone Number: | 3093444250 |
Fax Number: | 3093444368 |
NPI Enumeration Date: | 11/23/2009 |
NPI Last Update Date: | 11/23/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 163WP0808X |
License Number: | 110625 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IA |
Taxonomy Type: | Nursing Service Providers |
Taxonomy Classification: | Registered Nurse |
Taxonomy Specialization: | Psych/Mental Health |
Taxonomy Definition: |