Jennings E. Mooneyhan, SA-C
Specialist/Technologist, Other, Surgical Assistant in Jacksonville Beach, FL. Individual provider (NPI-1).
NPI number1790107928
StatusActive
Last updated in NPPESJan 7, 2014
Details
- NPI
- 1790107928
- Entity type
- Individual (NPI-1)
- Name
- Mr. Jennings E. Mooneyhan
- Credential
- SA-C
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Jan 7, 2014
- Last updated
- Jan 7, 2014
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 246ZC0007X | Specialist/Technologist, Other, Surgical Assistant | 94-122 | TN | Yes |
Other names
- Jennings E Mooneyhan (Professional Name)
Practice location
1310 1st St SJacksonville Beach, FL 32250-6404
Phone 904-222-5491 · Fax 904-627-1609
Mailing address
1310 1st St SJacksonville Beach, FL 32250-6404
Phone 904-222-5491 · Fax 904-627-1609
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