ATHENA MOON (NPI# 1528511169) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528511169 |
| Entity Type | Individual |
| Full Name | ATHENA MOON |
| Credential | FNP |
| Practice Address |
3001 W University Blvd Odessa TX 79764-7129 |
| Practice Telephone | 4325805966 |
| Enumeration Date | 2016-08-01 |
| Last Update Date | 2016-08-01 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
AP131550 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295877405 | Athena Marie Moon | Speech-Language Pathologist | 10917 N Dale Mabry Hwy, Tampa, FL 33618-4112 | 2007-02-13 |
| Street Address |
3001 W UNIVERSITY BLVD |
| City | ODESSA |
| State | TX |
| Zip Code | 79764-7129 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881784098 | Joe L Wallace, Mdpa | Family Medicine | 3001 W University Blvd, Odessa, TX 79764-7129 | 2006-10-16 |
| 1063822443 | Nahyung Choi | Nurse Practitioner | 3001 W University Blvd, Odessa, TX 79764-7129 | 2014-05-06 |
| 1609128594 | Amanda Lynn Paradeaux | Nurse Practitioner | 3001 W University Blvd, Odessa, TX 79764 | 2012-10-03 |
| 1114292398 | Annalee Mora | Nurse Practitioner | 3001 W University Blvd, Odessa, TX 79764-7129 | 2012-03-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710466610 | Cvs Pharmacy Inc | Durable Medical Equipment & Medical Supplies | 3050 W University Blvd, Odessa, TX 79764 | 2018-08-10 |
| 1962897405 | H-e-b, Lp | Clinical Medical Laboratory | 2501 W. University Blvd, Odessa, TX 79764 | 2015-04-01 |
| 1184022758 | Md Moinul Islam | Physician Assistant | 6030 W. University, Odessa, TX 79764 | 2014-12-15 |
| 1962618637 | D&s Residential Services | Intermediate Care Facility, Mentally Retarded | 10036 West Westland Drive, Odessa, TX 79764 | 2007-05-16 |
| 1992119838 | Gary Chase Jackson | Optometrist | 6030 W University Blvd, Odessa, TX 79764 | 2014-06-18 |
| 1760619498 | Cindy A Smith | Speech-Language Pathologist | 8712 Claymoor Dr, Odessa, TX 79764-1252 | 2009-06-21 |
| 1003316084 | Maranda Pina Garza | Licensed Vocational Nurse | 24 Bookins Ct, Odessa, TX 79764-1401 | 2018-02-16 |
| 1255378717 | United Supermarkets LLC | Durable Medical Equipment & Medical Supplies | 2751 N County Rd W, Odessa, TX 79764-1665 | 2006-06-01 |
| 1578112454 | Shaikat Banerjee | Pharmacist | 2751 N County Rd W, Odessa, TX 79764-1665 | 2019-09-04 |
| 1821598939 | Maichel Roshdy | Pharmacist | 2751 N County Rd W, Odessa, TX 79764-1665 | 2018-02-15 |
| Find all providers in zip 79764 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639776115 | Taylor Marie Russell | Nurse Practitioner | 15217 Wind Whisper Dr, Odessa, FL 33556-1832 | 2020-10-07 |
| 1992310551 | Taylor Barnes | Nurse Practitioner | 5919 Fitzgerald Rd, Odessa, FL 33556-2355 | 2020-09-10 |
| 1558995753 | Mission Health, Pllc | Nurse Practitioner | 3112 San Saba Dr, Odessa, TX 79765-5058 | 2020-02-26 |
| 1710549084 | Alyce Greenwood | Nurse Practitioner | 16501 Harper Pond Ln Apt 301, Odessa, FL 33556-6101 | 2019-07-08 |
| 1073170411 | Trudian Alicia Lester | Nurse Practitioner | 8050 E Highway 191 Ste 104, Odessa, TX 79765-8614 | 2019-05-21 |
| 1043773153 | Janette Garcia | Nurse Practitioner | 420 E 6th St Ste 201b, Odessa, TX 79761-4572 | 2019-04-08 |
| 1073074258 | Courtney Clubb | Nurse Practitioner | 410 N Hancock Ave # 4, Odessa, TX 79761-5140 | 2019-03-28 |
| 1891256434 | Joann Mercedes Georges Guillory | Nurse Practitioner | 56 Berkshire Cir, Odessa, TX 79765-2218 | 2019-03-27 |
| 1689138521 | Jacqueline Alcantara | Nurse Practitioner | 15103 Virginia Sta Apt 214, Odessa, FL 33556-3579 | 2019-01-24 |
| 1841767597 | Michael Ebrada | Nurse Practitioner | 16400 Rollingbrook Dr, Odessa, FL 33556-4907 | 2018-10-31 |
| Find all providers in ODESSA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.