Individual
MOSELAINE ELAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
841 SW COLLEGE PARK RD, PORT ST LUCIE, FL 34953-3334
(772) 878-5772
Mailing address
841 SW COLLEGE PARK RD, PORT ST LUCIE, FL 34953-3334
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
CNA128405
FL
Other
Enumeration date
05/01/2007
Last updated
07/08/2007
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