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NPI Code Detail

MEDICARE: MS. SHAWNA MOFFETT CNM, FNP

MEDICARE: MS. SHAWNA MOFFETT CNM, FNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1367A00000XAdvanced Practice Midwife1-076701AL
2363LF0000XFamily Nurse Practitioner1-076701AL

General Provider Information

NPI Number : 1235139155
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. SHAWNA MOFFETT CNM, FNP
Provider Business Mailing Address
First Line : 4011 INDUSTRIAL PARK DR
Second Line :
City : CLANTON
State : AL
Zip : 35045-8629
Country : US
Telephone Number : 205-299-0804
Fax Number :
Provider Business Practice Location Address
First Line : 301 HEALTH CENTER DR
Second Line :
City : CLANTON
State : AL
Zip : 35045-2349
Country : US
Telephone Number : 205-755-1287
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/21/2005
Last Update Date : 02/08/2023

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