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General NPI Number Information
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NPI Number | 1447064928
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Entity Type | Organization
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Legal Business Name | MOONSTONE MENTAL HEALTH SERVICES PLLC
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Dates
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Enumeration Date | 02/04/2025
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Last Update Date | 02/04/2025
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Provider Practice Location Address
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Address Line | 1566 S GILBERT ST UNIT 1023
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City | IOWA CITY
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State | IA
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Zip | 52240-4304
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Country | US
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Telephone | 319-853-8378
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Fax |
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Provider Business Mailing Address
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Address Line | 1566 S GILBERT ST UNIT 1023
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City | IOWA CITY
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State | IA
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Zip | 52240-4304
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Country | US
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Telephone | 319-853-8378
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. KADESHA EVANS
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Credential | APRN
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Telephone | 319-853-8378
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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