Basic Information
Provider Information
NPI: 1912168444
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MOONEY
FirstName: DONNA
MiddleName: HANNAH
NamePrefix: MS.
NameSuffix:  
Credential: FNP-BC
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 602373
Address2:  
City: CHARLOTTE
State: NC
PostalCode: 282602373
CountryCode: US
TelephoneNumber: 8282502833
FaxNumber:  
Practice Location
Address1: 428 BILTMORE AVE
Address2:  
City: ASHEVILLE
State: NC
PostalCode: 288014502
CountryCode: US
TelephoneNumber: 8282135253
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/18/2008
LastUpdateDate: 08/10/2011
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LF0000XAP 60021582WAY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily

No ID Information.


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