MEDICARE: JENNIFER RENAE MOSIER

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	0024197006	VA

General Provider Information

NPI Number	:	1699643874
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER RENAE MOSIER

Provider Business Mailing Address
First Line	:	3000 CEDAR SPRINGS RD
Second Line	:
City	:	SUGAR GROVE
State	:	VA
Zip	:	24375-3240
Country	:	US
Telephone Number	:	276-759-4048
Fax Number	:

Provider Business Practice Location Address
First Line	:	3000 CEDAR SPRINGS RD
Second Line	:
City	:	SUGAR GROVE
State	:	VA
Zip	:	24375-3240
Country	:	US
Telephone Number	:	276-759-4048
Fax Number	:

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

Provider Enumeration Date	:	10/28/2025
Last Update Date	:	04/06/2026

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