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NPI Code Detail

MEDICARE: MOLLIE MOSS APRN, FNP-BC

MEDICARE: MOLLIE MOSS APRN, FNP-BC
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
1363LF0000XFamily Nurse Practitioner4012697KY

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 : 1811759970
Entity Type Code : Individual
Provider Name (Legal Business Name) : MOLLIE MOSS APRN, FNP-BC
Provider Business Mailing Address
First Line : PO BOX 936
Second Line :
City : LONDON
State : KY
Zip : 40743-0936
Country : US
Telephone Number : 606-330-7835
Fax Number : 859-744-1177
Provider Business Practice Location Address
First Line : 1850 BYPASS RD
Second Line :
City : WINCHESTER
State : KY
Zip : 40391-2300
Country : US
Telephone Number : 859-744-5111
Fax Number : 859-744-1177
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/24/2024
Last Update Date : 01/12/2026

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