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General NPI Number Information
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NPI Number | 1801333281
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Entity Type | Individual
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Provider Name | ASHLEY MOSE N.P.
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Gender | Female
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Dates
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Enumeration Date | 01/24/2017
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Last Update Date | 08/02/2021
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Provider Practice Location Address
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Address Line | 80 JESSE HILL DR SE
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City | ATLANTA
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State | GA
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Zip | 30303-3030
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Country | US
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Telephone | 404-616-5525
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Fax |
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Provider Business Mailing Address
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Address Line | 8730 PUETT DR
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City | DOUGLASVILLE
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State | GA
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Zip | 30135-7549
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Country | US
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Telephone | 251-709-2591
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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 | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 95005755
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License Number State | CA
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