Moore, Mandy Lynn

Moore, Mandy Lynn is an individual health care provider with primary practice located at 1920 Don Wickham Drive Suit 330, Clermont FL 34711. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as her primary health care specialty. Moore, Mandy Lynn can be contacted via phone (352) 241-4298.

Contact Information

Primary practice address
1920 Don Wickham Drive Suit 330 Clermont FL 34711
Phone: (352) 241-4298
Fax: (352) 241-7620
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X ARNP9207746 Florida

Profile Details

NPI number 1396168118
LBN Legal business name Moore, Mandy Lynn
Credentials ARNP
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 30th, 2014
Last updated Apr 5th, 2016 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1396168118 NPPES
Florida MEDICAID 012103300

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