Healthcare Provider Details

I. General information

NPI: 1033057153
Provider Name (Legal Business Name): RACHEL MOSLEY FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/23/2026
Last Update Date: 03/23/2026
Certification Date: 03/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

241 STONEBRIDGE BLVD STE B
JACKSON TN
38305-2180
US

IV. Provider business mailing address

241 STONEBRIDGE BLVD STE B
JACKSON TN
38305-2180
US

V. Phone/Fax

Practice location:
  • Phone: 731-660-2056
  • Fax:
Mailing address:
  • Phone: 731-660-2056
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number239437
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: