Healthcare Provider Details

I. General information

NPI: 1679069231
Provider Name (Legal Business Name): VASHAWN RENEE MOSLEY FNPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2018
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2634 CAPITAL CIR NE
TALLAHASSEE FL
32308-4106
US

IV. Provider business mailing address

PO BOX 7
COLQUITT GA
39837-0007
US

V. Phone/Fax

Practice location:
  • Phone: 850-523-3333
  • Fax:
Mailing address:
  • Phone: 229-758-5902
  • Fax: 229-758-8227

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN9306513
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberRN203847
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: