Mooney, Debra Russell

Mooney, Debra Russell is an individual health care provider with primary practice located at 103 Pennsylvania Ave , Charleston WV 25302-2314. She recently has only one registered license in Allopathic & Osteopathic Physicians / Addiction Psychiatry, which is considered as her primary health care specialty. Mooney, Debra Russell can be contacted via phone (304) 756-5715.

Contact Information

Primary practice address
103 Pennsylvania Ave Charleston WV 25302-2314
Phone: (304) 756-5715
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Addiction Psychiatry 2084P0802X 26602 West Virginia

Profile Details

NPI number 1023094729
LBN Legal business name Mooney, Debra Russell
Credentials C-FNP
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 15th, 2005
Last updated Mar 21st, 2023 - about 3 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 1023094729 NPPES
West Virginia MEDICAID 0116688000

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