Individual
MRS. NANCY M. CHAVEZ-MOZINGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
IDMT
Contact information
Practice address
7050 AIR DEPOT BLVD, TINKER AFB, OK 73145-8716
(405) 734-2778
Mailing address
7050 AIR DEPOT BLVD, TINKER AFB, OK 73145-8716
Taxonomy
Speciality
Code
Description
License number
State
1710I1003X
Independent Duty Medical Technicians
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1497084180
USAF
—
Enumeration date
12/09/2009
Last updated
11/26/2018
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