Healthcare Provider Details

I. General information

NPI: 1326112871
Provider Name (Legal Business Name): MONICA MOSLEY SPENCER RN, FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MONICA MARIE MOSLEY RN, FNP

II. Dates (important events)

Enumeration Date: 11/17/2006
Last Update Date: 05/03/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3500 GASTON AVE BARNETT TOWER, #210
DALLAS TX
75246-2017
US

IV. Provider business mailing address

1283 PALMYRA RD
PALMER TX
75152-8051
US

V. Phone/Fax

Practice location:
  • Phone: 214-820-4400
  • Fax:
Mailing address:
  • Phone: 214-681-7830
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number548087
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: