Mooneyham Properties

NPI #1184913014 in Brandon, Mississippi

Provider Information

NPI Number: 1184913014
Entity Type: Organization
Organization Name: Mooneyham Properties
Primary Specialty: Clinic/Center
Enumeration Date: Mar 31, 2011
Last Updated: Mar 31, 2011

Practice Location

Address: 1127 OLD FANNIN RD
Address 2: C
City: Brandon
State: Mississippi
ZIP Code: 39047-9265
Phone: (601) 214-4420

Authorized Official

Name: MRS. JENNIFER WEDGEWORTH MOONEYHAM, FNP-BC
Title: PROVIDER/OWNER
Phone: (601) 214-4420

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center	261Q00000X	Primary

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