MEDICARE: CAROLYN O'LEARY MOSIER RN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163WL0100X	Lactation Consultant (Registered Nurse)	0001168291	VA

General Provider Information

NPI Number	:	1053471334
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAROLYN O'LEARY MOSIER RN

Provider Business Mailing Address
First Line	:	6440 OVERBROOK ST
Second Line	:
City	:	FALLS CHURCH
State	:	VA
Zip	:	22043-1944
Country	:	US
Telephone Number	:	703-599-9180
Fax Number	:

Provider Business Practice Location Address
First Line	:	6440 OVERBROOK ST
Second Line	:
City	:	FALLS CHURCH
State	:	VA
Zip	:	22043-1944
Country	:	US
Telephone Number	:	703-599-9180
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/09/2006
Last Update Date	:	01/14/2025

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