Most Relevant Information
Provider Data
| NPI Number: | 1003446451 |
| Provider Name: | IFEOMA NNEKA MOZIE AGACNP |
| Entity Type: | Individual |
| Taxonomy Code: | 363LA2100X |
| Specialty: | Nurse Practitioner |
| License Number: | 30101 |
Most Important Dates
| Enumeration Date: | 01/23/2020 |
| Last Updated: | 01/23/2020 |
Provider Practice Location
350 S 40TH ST
MUSKOGEE
OK
744014915
Practice Location Phone/Fax
| Phone: | 9186830753 |
| Fax: | 9186835677 |
Provider Mailing Location
350 S 40TH ST
MUSKOGEE
OK
744014915
Provider Mailing Phone/Fax
| Phone: | 9186830753 |
| Fax: | 9186835677 |