Healthcare Provider Details

I. General information

NPI: 1255173399
Provider Name (Legal Business Name): JULIA PAULSON MOSELEY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/10/2024
Last Update Date: 10/15/2025
Certification Date: 10/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2245 E COUNTRY CLUB DR
SALT LAKE CITY UT
84109-1545
US

IV. Provider business mailing address

2245 E COUNTRY CLUB DR
SALT LAKE CITY UT
84109-1545
US

V. Phone/Fax

Practice location:
  • Phone: 303-819-5930
  • Fax:
Mailing address:
  • Phone: 303-819-5930
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number12321862-4405
License Number StateUT
# 2
Primary TaxonomyN
Taxonomy Code163WX0200X
TaxonomyOncology Registered Nurse
License Number12321862-3102
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: