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General NPI Number Information
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NPI Number | 1548445562
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Entity Type | Individual
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Provider Name | MELINDA S MOSBY NP
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Gender | Female
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Dates
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Enumeration Date | 01/09/2008
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Last Update Date | 05/17/2018
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Provider Practice Location Address
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Address Line | 238 SUMMAR DR
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City | JACKSON
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State | TN
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Zip | 38301
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Country | US
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Telephone | 731-541-8200
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Fax | 731-541-8327
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Provider Business Mailing Address
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Address Line | 1804 HIGHWAY 45 BYP STE 604
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City | JACKSON
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State | TN
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Zip | 38305-4403
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Country | US
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Telephone | 731-660-8781
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Fax | 731-660-8739
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN0000124100
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 19834
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License Number State | TN
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