Healthcare Provider Details

I. General information

NPI: 1487150124
Provider Name (Legal Business Name): PATRICE MOSLEY-WILLIAMS WHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: PATRICE MOSLEY

II. Dates (important events)

Enumeration Date: 04/02/2018
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2003 STULTS RD STE 200
HUNTINGTON IN
46750-1291
US

IV. Provider business mailing address

11109 PARKVIEW PLAZA DR # 117
FORT WAYNE IN
46845-1701
US

V. Phone/Fax

Practice location:
  • Phone: 260-355-3960
  • Fax: 260-355-3969
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number09000531A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License Number28190080A
License Number StateIN
# 3
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number71008298A
License Number StateIN
# 4
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number71008298A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: