MEDICARE: STEPHANIE MOSLEY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	0000013136	TN
2	1835P0018X	Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist	13136	TN

General Provider Information

NPI Number	:	1427365279
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHANIE MOSLEY

Provider Business Mailing Address
First Line	:	7942 WINCHESTER RD
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38125-2306
Country	:	US
Telephone Number	:	901-758-3615
Fax Number	:

Provider Business Practice Location Address
First Line	:	7942 WINCHESTER RD
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38125-2306
Country	:	US
Telephone Number	:	901-758-3615
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/31/2010
Last Update Date	:	01/28/2020

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Directions to “ STEPHANIE MOSLEY ” Practice Location

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