Provider Demographics
NPI:1003158452
Name:MOONEY, ANNA FRANKLIN
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:FRANKLIN
Last Name:MOONEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 FALCON CREST LN
Mailing Address - Street 2:HAYWOOD PROFESSIONAL PARK
Mailing Address - City:CLYDE
Mailing Address - State:NC
Mailing Address - Zip Code:28721-6620
Mailing Address - Country:US
Mailing Address - Phone:828-452-8878
Mailing Address - Fax:828-452-8879
Practice Address - Street 1:55 BUCKEYE COVE RD STE 200A
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:NC
Practice Address - Zip Code:28716-4511
Practice Address - Country:US
Practice Address - Phone:284-528-8788
Practice Address - Fax:828-452-8879
Is Sole Proprietor?:No
Enumeration Date:2013-03-25
Last Update Date:2022-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NC2016-00348208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program