Healthcare Provider Details

I. General information

NPI: 1336175900
Provider Name (Legal Business Name): BARBARA ANN MOSELEY CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: BARBARA ANN CROSBY CNP

II. Dates (important events)

Enumeration Date: 06/24/2006
Last Update Date: 11/05/2020
Certification Date: 11/05/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3619 PARK EAST DR STE 109
BEACHWOOD OH
44122-4312
US

IV. Provider business mailing address

3619 PARK EAST DR STE 109
BEACHWOOD OH
44122-4312
US

V. Phone/Fax

Practice location:
  • Phone: 216-464-6210
  • Fax: 216-464-6212
Mailing address:
  • Phone: 216-464-6210
  • Fax: 216-464-6212

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberNP-03791
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number03791
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number03791
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: