Most Relevant Information
Provider Data
| NPI Number: | 1003219056 |
| Provider Name: | SHELLY AMANDA MOSELY NP |
| Entity Type: | Individual |
| Taxonomy Code: | 363LA2200X |
| Specialty: | Nurse Practitioner |
| License Number: | 9218485 |
Most Important Dates
| Enumeration Date: | 10/06/2014 |
| Last Updated: | 02/11/2022 |
Provider Practice Location
2550 SE WALTON RD
PORT ST LUCIE
FL
349527168
Practice Location Phone/Fax
| Phone: | 7723350400 |
| Fax: |
Provider Mailing Location
6526 S KANNER HWY
#223
STUART
FL
349976396
Provider Mailing Phone/Fax
| Phone: | 7728343807 |
| Fax: |