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NPI Code Detail

MEDICARE: BRITTANY MOOSE

MEDICARE: BRITTANY MOOSE
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
13747P1801XPersonal Care AttendantNV

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1053812776
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRITTANY MOOSE
Provider Business Mailing Address
First Line : 141 CATLIN ST
Second Line :
City : DAYTON
State : NV
Zip : 89403-9798
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 343 FAIRVIEW DR STE 101
Second Line :
City : CARSON CITY
State : NV
Zip : 89701-5389
Country : US
Telephone Number : 775-887-5683
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/27/2018
Last Update Date : 02/27/2018

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Directions to “ BRITTANY MOOSE ” Practice Location

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