Provider Demographics
NPI:1487321428
Name:MORING, KEVIN FREDERICK (LPN)
Entity type:Individual
Prefix:
First Name:KEVIN
Middle Name:FREDERICK
Last Name:MORING
Suffix:
Gender:M
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2246 KIWI TRL
Mailing Address - Street 2:
Mailing Address - City:CLERMONT
Mailing Address - State:FL
Mailing Address - Zip Code:34714-8017
Mailing Address - Country:US
Mailing Address - Phone:407-453-1943
Mailing Address - Fax:
Practice Address - Street 1:2246 KIWI TRL
Practice Address - Street 2:
Practice Address - City:CLERMONT
Practice Address - State:FL
Practice Address - Zip Code:34714-8017
Practice Address - Country:US
Practice Address - Phone:407-453-1943
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-26
Last Update Date:2021-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPN869131164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse