Shannon L Moffett is a Acute Care in Jackson, Mississippi. Shannon L Moffett practices all healthcare services and medical treatments related to Acute Care. The NPI Number for Shannon L Moffett is 1174606289. The last update date is 2016-06-29.
Shannon L Moffett's current location address is 2500 N State St, Jackson, Mississippi. You can contact this provider via phone number 6019846426 and fax number 6019846439. The mailing address for Shannon L Moffett is 2500 N State St, Jackson, Mississippi. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Shannon L Moffett |
|---|---|
| Address | 2500 N State St, Jackson, Mississippi |
| Phone Number | 6019846426 |
| Fax Number | 6019846439 |
| Sole Proprietor | N |
| Credentials | NP |
NPI Number Detail
| NPI Number | 1174606289 |
|---|---|
| Provider Enumeration Date | 2006-10-23 |
| Last Updated Date | 2016-06-29 |
Provider Mailing Address Detail
| Address | 2500 N State St |
|---|---|
| City | Jackson |
| State | Mississippi (MS) |
| Post Code | 392164500 |
| Phone Number | 6019846426 |
| Fax Number | 6019846439 |
Provider's Primary Taxonomy Detail
| Speciality | Acute Care |
|---|---|
| Taxonomy | 363La2100X |
| Licence No | R857161 |
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Definition: An advanced practice registered nurse expert in providing care to adults and older children with complex acute, critical, and chronic health conditions. |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 6188884 | MS | -- | |
| P01648526 | MS | RAILROAD MEDICARE PTAN |
Post Comment/ Review Below
What is the unique identifier code issued to Shannon L Moffett by the Centers for Medicare & Medicaid Services (CMS)?
The Shannon L Moffett has been assigned the NPI (National Provider Identifier) 1174606289. This 10-digit code serves as a unique identification number for healthcare providers, issued by the CMS.
Could you share the physical location details of Shannon L Moffett?
The Shannon L Moffett is situated at 2500 N State St, in the city of Jackson, state of MS, with the zip code 392164500.
What is Shannon L Moffett's primary area of medical expertise, and what taxonomy classification code corresponds to this specialized field?
The primary area of medical expertise for Shannon L Moffett is Acute Care, and the corresponding taxonomy classification code for this specialized field is 363La2100X.
On what date did Shannon L Moffett receive its 1174606289 assignment from the Centers for Medicare & Medicaid Services?
The Shannon L Moffett was assigned its 1174606289 on 2006-10-23, which is the date when this unique identifier was issued to the organization by the Centers for Medicare & Medicaid Services.
As of what date were the details related to Shannon L Moffett most recently updated or revised?
The information pertaining to Shannon L Moffett, including its address, specialty, and other relevant details, was last updated or revised on 2016-06-29.