Healthcare Provider Details

I. General information

NPI: 1700028453
Provider Name (Legal Business Name): CHRISTINE JUNE MOSER-HARRIS RN,ANP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CHRISTINE JUNE MOSER RN,ANP

II. Dates (important events)

Enumeration Date: 03/27/2009
Last Update Date: 12/02/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 W VALENCIA RD STE 110
TUCSON AZ
85746-6003
US

IV. Provider business mailing address

5055 E BROADWAY BLVD SUITE A-100
TUCSON AZ
85711-3640
US

V. Phone/Fax

Practice location:
  • Phone: 520-751-3335
  • Fax: 520-751-3312
Mailing address:
  • Phone: 520-327-0460
  • Fax: 520-795-0225

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number50486
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberAP3879
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: