Individual
DEREK MOSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BSN, RN
Contact information
Practice address
650 ROUND VALLEY DR, PARK CITY, UT 84060-7571
(435) 333-1504
Mailing address
650 ROUND VALLEY DR, PARK CITY, UT 84060-7571
(435) 333-1504
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
4828635-3102
UT
163WA2000X
Administrator Registered Nurse
4828635-3102
UT
Other
Enumeration date
07/06/2023
Last updated
07/06/2023
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