Individual
STEPHAN MICHAEL MOSS
Active
Individual
STEPHAN MICHAEL MOSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
163WE0003X
Emergency Registered Nurse
10566698-3102
UT
363LF0000X
Family Nurse Practitioner
Primary
10566698-4405
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10566698-4405
LICENSE
UT
Enumeration date
06/15/2018
Last updated
11/21/2018
Update your record
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