Individual
VICKI ANN MOCEO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP-BC
Contact information
Practice address
805 N DICKINSON DRIVE, RUSK, TX 75785
(903) 683-7201
(903) 683-7199
Mailing address
PO BOX 488, JACKSONVILLE, TX 75766-0488
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
559374
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00000238225
STATE ID
TX
01
—
559374
LICENSE
TX
Enumeration date
02/06/2013
Last updated
02/06/2013
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