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Individual
KHAMPHOU MANIVANH MOSLEY
Active
Individual
KHAMPHOU MANIVANH MOSLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
21726
SC
363L00000X
Nurse Practitioner
5010768
NC
363LF0000X
Family Nurse Practitioner
Primary
APRN11002153
FL
Other
Enumeration date
05/15/2018
Last updated
06/25/2024
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