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NPI Code Detail

MEDICARE: KRISTAL MOSES FNP-C

MEDICARE: KRISTAL MOSES FNP-C
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
1363LF0000XFamily Nurse Practitioner32036SC

General Provider Information

NPI Number : 1841123593
Entity Type Code : Individual
Provider Name (Legal Business Name) : KRISTAL MOSES FNP-C
Provider Business Mailing Address
First Line : 809 N CEDAR ST
Second Line :
City : SUMMERVILLE
State : SC
Zip : 29483-6605
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 809 N CEDAR ST
Second Line :
City : SUMMERVILLE
State : SC
Zip : 29483-6605
Country : US
Telephone Number : 843-871-9440
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/03/2026
Last Update Date : 06/03/2026

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Directions to “ KRISTAL MOSES FNP-C” Practice Location

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