Moffett, Jeffrey R.

Moffett, Jeffrey R. is an individual health care provider with primary practice located at 3115 Audubon Dr , Laurel MS 39440. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as his primary health care specialty. Moffett, Jeffrey R. can be contacted via phone (601) 531-2200.

Contact Information

Primary practice address
3115 Audubon Dr Laurel MS 39440
Phone: (601) 531-2200
Fax: (601) 531-2220
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X R872112 Mississippi

Profile Details

NPI number 1710135629
LBN Legal business name Moffett, Jeffrey R.
Credentials Family Nurse Practitioner (FNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 4th, 2008
Last updated Apr 4th, 2019 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1710135629 NPPES
Mississippi MEDICAID 00753295

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