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MOSES ENAKIRUVIE EKAKITIE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
6101 NW 29TH ST, GAINESVILLE, FL 32653-1851
(352) 363-4045
Mailing address
6101 NW 29TH ST, GAINESVILLE, FL 32653-1851
(352) 363-4045

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
11015006
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
11015006
FL
Enumeration date
10/01/2021
Last updated
10/01/2021
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