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General NPI Number Information
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NPI Number | 1629966536
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Entity Type | Individual
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Provider Name | MARY SUSAN MOSS DNP
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Gender | Female
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Dates
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Enumeration Date | 06/27/2025
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Last Update Date | 06/27/2025
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Provider Practice Location Address
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Address Line | 20 DUKE MEDICINE CIR
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City | DURHAM
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State | NC
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Zip | 27710-2000
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Country | US
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Telephone | 919-421-8158
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Fax | 919-613-4082
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Provider Business Mailing Address
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Address Line | 510 MAGNA DR
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City | DURHAM
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State | NC
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Zip | 27703-6357
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Country | US
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Telephone | 336-314-8527
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Fax | 336-314-8527
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 5022489
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License Number State | NC
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