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General NPI Number Information
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NPI Number | 1003607961
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Entity Type | Individual
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Provider Name | DENVER MOSES NP
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Gender | Male
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Dates
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Enumeration Date | 05/13/2025
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Last Update Date | 05/13/2025
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Provider Practice Location Address
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Address Line | 41800 W 11 MILE RD STE 109
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City | NOVI
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State | MI
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Zip | 48375-1818
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Country | US
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Telephone | 248-660-1220
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Fax |
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Provider Business Mailing Address
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Address Line | 248 LEACH CIR APT 3
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City | JONESBOROUGH
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State | TN
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Zip | 37659-5867
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Country | US
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Telephone | 423-494-4485
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 364SL0600X
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Taxonomy Name | Long-Term Care Clinical Nurse Specialist
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License Number | 4704427620
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License Number State | MI
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