Individual
SHARON BLAIR-MOXAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
5164 VIZCAYA ST, AVE MARIA, FL 34142-9602
(754) 368-5488
Mailing address
5164 VIZCAYA ST, AVE MARIA, FL 34142-9602
(754) 368-5488
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
11034079
FL
Other
Enumeration date
07/30/2024
Last updated
07/30/2024
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