Individual
FITZWILLIAM ESELE MUSOKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN
Contact information
Practice address
1024 W OWENS AVE, LAS VEGAS, NV 89106-2520
(813) 420-5470
Mailing address
464 BEARDSLEY CIR, HENDERSON, NV 89052-2670
(813) 420-5470
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
827678
NV
363L00000X
Nurse Practitioner
APRN9342679
FL
363LF0000X
Family Nurse Practitioner
APRN9342679
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
018432500
—
FL
01
—
AJW4L
BCBS
FL
01
—
APRN827678
NV APRN LICENSE
NV
01
—
APRN9342679
FL LICENSE
—
Enumeration date
08/08/2016
Last updated
03/07/2023
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