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Individual

RICHARD A MOSS

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
4500 W 69TH ST, SIOUX FALLS, SD 57108-8148
(605) 977-7000
(605) 977-7001
Mailing address
4500 W 69TH ST, SIOUX FALLS, SD 57108-8148
(605) 977-7000
(605) 977-7001

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R014760
SD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0008161
WELLMARK
SD
05
5751770
SD
Enumeration date
09/20/2005
Last updated
07/08/2007
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