MEDICARE: SARA MOSS

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	279161	AZ

General Provider Information

NPI Number	:	1376321901
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARA MOSS

Provider Business Mailing Address
First Line	:	6137 E GRANT RD
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85712-5829
Country	:	US
Telephone Number	:	520-258-1739
Fax Number	:	520-363-6092

Provider Business Practice Location Address
First Line	:	6137 E GRANT RD
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85712-5829
Country	:	US
Telephone Number	:	520-258-1739
Fax Number	:	520-363-6092

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

Provider Enumeration Date	:	09/15/2023
Last Update Date	:	09/04/2025

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Directions to “ SARA MOSS ” Practice Location

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