Individual
JENNIFER L MOES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
1454 MADISON AVE W, IMMOKALEE, FL 34142-2200
(239) 658-3707
Mailing address
6360 TECHSTER BLVD, FORT MYERS, FL 33966-4805
(239) 223-2751
(239) 561-2933
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
APRN9461847
FL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
ARNP9461847
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
023011900
—
FL
Enumeration date
07/03/2006
Last updated
07/21/2022
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