Individual
JESSICA MOSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
805 N ORANGE ST, BUTLER, MO 64730-9382
(660) 200-7042
Mailing address
510 N MISSOURI ST, APPLETON CITY, MO 64724-1474
(816) 888-9110
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
2019000795
MO
Other
Enumeration date
07/01/2019
Last updated
07/01/2019
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