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NPI Code Detail

MEDICARE: NICOLE JULIANA MOSS MD

MEDICARE: NICOLE JULIANA MOSS MD
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
1207V00000XObstetrics & Gynecology Physician9708NV

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1821060856
Entity Type Code : Individual
Provider Name (Legal Business Name) : NICOLE JULIANA MOSS MD
Provider Business Mailing Address
First Line : 2931 N TENAYA WAY
Second Line : SUITE 204
City : LAS VEGAS
State : NV
Zip : 89128-0456
Country : US
Telephone Number : 702-233-2123
Fax Number : 702-233-0398
Provider Business Practice Location Address
First Line : 2931 N TENAYA WAY
Second Line : SUITE 204
City : LAS VEGAS
State : NV
Zip : 89128-0456
Country : US
Telephone Number : 702-233-2123
Fax Number : 702-233-0398
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/03/2006
Last Update Date : 10/01/2009

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Directions to “ NICOLE JULIANA MOSS MD” Practice Location

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