KHAMPHOU MANIVANH MOSLEY

ST LUCIE MEDICAL SPECIALISTS LLC

Dr KHAMPHOU MANIVANH MOSLEY is a female medical professional, specializing in Nurse Practitioner. She graduated in 2017.

Contact

ST LUCIE MEDICAL SPECIALISTS LLC

1713 US HWY 441 N
SUITE C
OKEECHOBEE
FL
349721900

Tel: 8634672159

KHAMPHOU MANIVANH MOSLEY Information

Npi 1093205049
Pac Id 2668723842
Professional Enrollment Id I20190614000402
Last Name MOSLEY
First Name KHAMPHOU
Middle Name MANIVANH
Suffix
Gender F
Credential
Medical School Name OTHER
Graduation Year 2017
Primary Specialty NURSE PRACTITIONER
Secondary Specialty 1
Secondary Specialty 2
Secondary Specialty 3
Secondary Specialty 4
All Secondary Specialties
Organization Legal Name ST LUCIE MEDICAL SPECIALISTS LLC
Group Practice Pac Id 1456430487
Number Of Group Practice Members 34
Line 1 Street Address 1713 US HWY 441 N
Line 2 Street Address SUITE C
Marker Of Address Line 2 Suppression
City OKEECHOBEE
State FL
Zip Code 349721900
Phone Number 8634672159
Hospital Affiliation Ccn 1
Hospital Affiliation Lbn 1
Hospital Affiliation Ccn 2
Hospital Affiliation Lbn 2
Hospital Affiliation Ccn 3
Hospital Affiliation Lbn 3
Hospital Affiliation Ccn 4
Hospital Affiliation Lbn 4
Hospital Affiliation Ccn 5
Hospital Affiliation Lbn 5
Professional Accepts Medicare Assignment Y

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