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General NPI Number Information
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NPI Number | 1346858990
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Entity Type | Individual
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Provider Name | MUUN QUEEN MALONE APRN, ACCNS-AG, FNP
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Gender | Female
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Dates
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Enumeration Date | 07/20/2020
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Last Update Date | 04/06/2022
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Provider Practice Location Address
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Address Line | 200 STANDING OAK PL
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City | FAYETTEVILLE
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State | GA
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Zip | 30214-2693
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Country | US
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Telephone | 757-581-3998
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Fax |
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Provider Business Mailing Address
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Address Line | 200 STANDING OAK PL
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City | FAYETTEVILLE
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State | GA
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Zip | 30214-2693
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Country | US
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Telephone | 757-581-3998
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 364SA2100X
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Taxonomy Name | Acute Care Clinical Nurse Specialist
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License Number | RN200581
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | RN200581
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License Number State | GA
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