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NPI Code Detail

MEDICARE: JENNIFER LEANN MOSER

MEDICARE: JENNIFER LEANN MOSER
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
1367500000XCertified Registered Nurse AnesthetistAPN11895TN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
24118347OTHERTNBCBS

General Provider Information

NPI Number : 1306806690
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIFER LEANN MOSER
Provider Business Mailing Address
First Line : 7947 EUREKA RD NW
Second Line :
City : CHARLESTON
State : TN
Zip : 37310-5107
Country : US
Telephone Number : 423-290-4801
Fax Number :
Provider Business Practice Location Address
First Line : 2333 MCCALLIE AVE
Second Line :
City : CHATTANOOGA
State : TN
Zip : 37404-3258
Country : US
Telephone Number : 423-698-6061
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/23/2006
Last Update Date : 04/10/2023

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Directions to “ JENNIFER LEANN MOSER ” Practice Location

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