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General NPI Number Information
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NPI Number | 1265942924
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Entity Type | Individual
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Provider Name | ASHLEY NICOLE MOSS PA
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Gender | Female
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Dates
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Enumeration Date | 10/09/2017
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Last Update Date | 01/13/2025
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Provider Practice Location Address
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Address Line | 10920 MCKINLEY DR
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City | TAMPA
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State | FL
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Zip | 33612-6471
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Country | US
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Telephone | 813-745-4673
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Fax |
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Provider Business Mailing Address
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Address Line | 1497 WHISPER WIND LN
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City | OLDSMAR
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State | FL
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Zip | 34677-5131
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Country | US
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Telephone | 727-519-5788
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA9110736
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License Number State | FL
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