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General NPI Number Information
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NPI Number | 1700324043
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Entity Type | Individual
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Provider Name | NICOLE MOSLEY NP
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Gender | Female
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Dates
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Enumeration Date | 02/07/2017
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Last Update Date | 03/14/2017
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Provider Practice Location Address
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Address Line | 4360 JOHNSON FERRY PL HEARTLAND CARE PARTNERS
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City | MARIETTA
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State | GA
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Zip | 30068-2063
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Country | US
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Telephone | 800-427-1902
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Fax | 419-531-2264
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Provider Business Mailing Address
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Address Line | 333 N SUMMIT ST FL 7 HCR MANORCARE MEDICAL SERVICES OF FLORIDA LLC
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City | TOLEDO
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State | OH
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Zip | 43604-2615
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Country | US
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Telephone | 419-252-6031
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Fax | 800-564-5952
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | RN198743
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License Number State | GA
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