MEDICARE: MRS. ASHLEY MARIE MOSHER 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	163WS0200X	School Registered Nurse	RN.339990	OH

General Provider Information

NPI Number	:	1689219008
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ASHLEY MARIE MOSHER RN

Provider Business Mailing Address
First Line	:	1728 DAYTON XENIA ROAD
Second Line	:
City	:	XENIA
State	:	OH
Zip	:	45385
Country	:	US
Telephone Number	:	937-458-2327
Fax Number	:

Provider Business Practice Location Address
First Line	:	1728 DAYTON XENIA ROAD
Second Line	:
City	:	XENIA
State	:	OH
Zip	:	45385
Country	:	US
Telephone Number	:	937-458-2327
Fax Number	:

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

Provider Enumeration Date	:	11/08/2019
Last Update Date	:	11/08/2019

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