Healthcare Provider Details

I. General information

NPI: 1376977876
Provider Name (Legal Business Name): HEATHER MARIE MOSLEY APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/03/2013
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 S 48TH ST STE 600
LINCOLN NE
68506-1275
US

IV. Provider business mailing address

1600 S 48TH ST STE 600
LINCOLN NE
68506-1275
US

V. Phone/Fax

Practice location:
  • Phone: 402-483-3333
  • Fax: 402-483-3297
Mailing address:
  • Phone: 402-483-3333
  • Fax: 402-483-3297

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number111562
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: