Individual
DERICK MOSTOLLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1086 FRANKLIN ST, JOHNSTOWN, PA 15905-4305
(814) 534-9000
Mailing address
3900 E INDIANTOWN RD, JUPITER, FL 33477-5085
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN674348
PA
Other
Enumeration date
10/13/2020
Last updated
01/27/2022
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