Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LW0102X | Nurse Practitioner - Women's Health | NP 990219 | CO |
NPI | 1073880043 |
---|---|
Provider Name | Amanda Louise Moseley |
First Address | Denver, CO 80207-1630 |
Second Address | Denver, CO 80207-1630 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/11/2011 |
Last Update Date | 18/11/2011 |