Healthcare Provider Details

I. General information

NPI: 1053537738
Provider Name (Legal Business Name): MS. BETH H MOSES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/18/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 WASHINGTON ST THIRD FLOOR
EAST STROUDSBURG PA
18301-2816
US

IV. Provider business mailing address

200 EAGLES CT
STROUDSBURG PA
18360-9773
US

V. Phone/Fax

Practice location:
  • Phone: 570-426-7150
  • Fax: 570-426-9484
Mailing address:
  • Phone: 570-422-1111
  • Fax: 570-422-1484

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SP0809X
TaxonomyAdult Psychiatric/Mental Health Clinical Nurse Specialist
License NumberRN228813-L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: