Healthcare Provider Details

I. General information

NPI: 1316483381
Provider Name (Legal Business Name): AMY R MOSSING APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/13/2017
Last Update Date: 01/22/2026
Certification Date: 01/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

702 COMMERCE DR STE 140
PERRYSBURG OH
43551-5272
US

IV. Provider business mailing address

702 COMMERCE DR STE 140
PERRYSBURG OH
43551-5272
US

V. Phone/Fax

Practice location:
  • Phone: 419-272-8005
  • Fax:
Mailing address:
  • Phone: 419-272-8005
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN199202
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number025373
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: