Moffitt, Jennifer Lynn

Moffitt, Jennifer Lynn is an individual health care provider with primary practice located at 2500 N State St , Jackson MS 39216-4500. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Neonatal, which is considered as her primary health care specialty. Moffitt, Jennifer Lynn can be contacted via phone (601) 815-7100.

Contact Information

Primary practice address
2500 N State St Jackson MS 39216-4500
Phone: (601) 815-7100
Fax: (601) 815-6987
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Neonatal 363LN0000X R570346 Mississippi

Profile Details

NPI number 1033154547
LBN Legal business name Moffitt, Jennifer Lynn
Credentials CNNP
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 18th, 2006
Last updated Dec 17th, 2013 - about 13 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 1033154547 NPPES
Louisiana MEDICAID 1433161
Louisiana MEDICAID 00122704

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