Moffett, Evelyn Denise

Moffett, Evelyn Denise is an individual health care provider with primary practice located at 1350 Hickory St Ste 102 , Melbourne FL 32901-3224. She recently has 2 registered licenses in different health care specialties including Nursing Service Providers / Critical Care Medicine, Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner. Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner is her primary health care specialty. Moffett, Evelyn Denise can be contacted via phone (321) 434-3455.

Contact Information

Primary practice address
1350 Hickory St Ste 102 Melbourne FL 32901-3224
Phone: (321) 434-3455
Fax: (321) 434-3456
Website:
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Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Critical Care Medicine 163WC0200X RN9332088 Florida
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X ARNP9332088 Florida

Profile Details

NPI number 1770012379
LBN Legal business name Moffett, Evelyn Denise
Credentials Advanced Practice Registered Nurse (APRN)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 7th, 2017
Last updated Mar 10th, 2020 - about 4 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 1770012379 NPPES
Florida Other JA626Z FL MEDICARE
Florida Other P02169610 FL MEDICARE
Florida MEDICAID 021420000 FL MEDICARE

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