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Individual

KELLEY BROWN MOORE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
217 SE 1ST AVE, OCALA, FL 34471-2161
(352) 877-9779
Mailing address
217 SE 1ST AVE, OCALA, FL 34471-2161
(352) 877-9779

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
PN1242581
FL
251E00000X
Home Health Agency
Primary
568
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
568
HOME HEALTH AGENCY EXEMPTION LICENSE
FL
Enumeration date
08/22/2022
Last updated
08/22/2022
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