Individual provider · Type 1 NPI

Jaden Rene Moomaw

Family Nurse Practitioner · Mattoon, IL

NPI number 1376298919 Active

Practice location

2512 Hurst Dr Ste 120
Mattoon, IL 61938-9200

Fax (217) 258-3686

Other practice locations

  • 6 Hairpin Dr, Edwardsville, IL 62026-1000 · (618) 650-3956

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program 390200000XNone listed
Family Nurse Practitioner Primary 363LF0000X209027942 (IL)

Family Nurse Practitioner: Definition to come...

7 other providers at this address

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About NPI 1376298919

Jaden Rene Moomaw's National Provider Identifier is 1376298919, issued on Feb 12, 2022. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Mattoon, IL. The record was last updated on Feb 29, 2024.