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General NPI Number Information
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NPI Number | 1548492945
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Entity Type | Individual
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Provider Name | ERICA COURTNEY MOSS APRN, FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 08/18/2009
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Last Update Date | 11/27/2023
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Provider Practice Location Address
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Address Line | 1201 HIGHWAY 49 S STE 1
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City | RICHLAND
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State | MS
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Zip | 39218-9438
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Country | US
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Telephone | 601-664-0055
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Fax |
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Provider Business Mailing Address
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Address Line | 92 BELLEGRASS BLVD
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City | HATTIESBURG
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State | MS
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Zip | 39402-1904
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Country | US
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Telephone | 601-421-1588
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | A03285
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License Number State | AR
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 905177
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License Number State | MS
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