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NPI Code Detail

MEDICARE: COLLEEN REILLY MOSS NNP

MEDICARE: COLLEEN REILLY MOSS NNP
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
1363LN0000XNeonatal Nurse Practitioner12603TN
2363LN0005XCritical Care Neonatal Nurse Practitioner12603TN
3363LN0000XNeonatal Nurse Practitioner11028942FL

Other Identifiers

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

General Provider Information

NPI Number : 1528250123
Entity Type Code : Individual
Provider Name (Legal Business Name) : COLLEEN REILLY MOSS NNP
Provider Business Mailing Address
First Line : 3841 GREEN HILLS VILLAGE DR STE 200
Second Line :
City : NASHVILLE
State : TN
Zip : 37215-2691
Country : US
Telephone Number :
Fax Number : 615-322-5048
Provider Business Practice Location Address
First Line : 3601 THE VANDERBILT CLINIC
Second Line :
City : NASHVILLE
State : TN
Zip : 37232-0001
Country : US
Telephone Number : 615-322-3000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/16/2007
Last Update Date : 12/15/2025

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