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MONICA LANCASTER MOON PA-C
>> Physician Assistant >> Physician Assistants & Advanced Practice Nursing ProvidersRegistrant NPI Number: 1275087439
Individual Registrant: MONICA LANCASTER MOON PA-C
Gender: F
Not Sole Proprietor
Gender: F
Not Sole Proprietor
Location and contact information for practice:
1212 E UNION ST VIENNA, GA 31092-7545 US
Tel: 229-268-8865 Fax: 229-268-8864
Tel: 229-268-8865 Fax: 229-268-8864
Contact information for business:
204 N WESTOVER BLVD ALBANY, GA 31707-2983 US
Tel: 229-888-6559 Fax: 229-436-4107
Tel: 229-888-6559 Fax: 229-436-4107
Registration Information:
NPI: 1275087439
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 363A00000X | Physician Assistants & Advanced Practice Nursing Providers Physician Assistant | GA | 008049 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
