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NPI Code Detail

MEDICARE: MONICA M MOSS

MEDICARE:   MONICA M MOSS
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
1164W00000XLicensed Practical Nurse114335OH

Other Identifiers

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

General Provider Information

NPI Number : 1841412921
Entity Type Code : Individual
Provider Name (Legal Business Name) : MONICA M MOSS
Provider Business Mailing Address
First Line : 2211 SUPERIOR AVE
Second Line :
City : SPRINGFIELD
State : OH
Zip : 45505-4743
Country : US
Telephone Number : 937-450-2207
Fax Number :
Provider Business Practice Location Address
First Line : 6100 CHANNINGWAY BLVD
Second Line : SUITE 700
City : COLUMBUS
State : OH
Zip : 43232-2910
Country : US
Telephone Number : 614-751-7777
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/02/2007
Last Update Date : 07/08/2007

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Directions to “ MONICA M MOSS ” Practice Location

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