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Individual

KOIESHA MOLME

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RN

Contact information

Practice address
1800 SE TIFFANY AVE, PORT SAINT LUCIE, FL 34952-7521
(407) 715-3310
Mailing address
P.O. BOX 2101, FORT PIERCE, FL 34950

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN9402229
FL
163WA0400X
Addiction (Substance Use Disorder) Registered Nurse
RN9402229
FL
163WP0807X
Child & Adolescent Psychiatric/Mental Health Registered Nurse
RN9402229
FL
163WP0808X
Psychiatric/Mental Health Registered Nurse
RN9402229
FL
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
RN9402229
FL
163WP2201X
Ambulatory Care Registered Nurse
RN9402229
FL

Other

Enumeration date
08/12/2017
Last updated
12/06/2018
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