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Individual

NICOLE MARIE MOSHER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP-C

Contact information

Practice address
602 IVY ST FL 2, ELMIRA, NY 14905-1646
(607) 735-4633
(607) 735-4628
Mailing address
571 SAINT JOSEPHS BLVD FL 2, ELMIRA, NY 14901-3230
(607) 271-2050
(607) 873-1244

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
336204
NY
363LF0000X
Family Nurse Practitioner
F336204-1
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
03196458
NY
Enumeration date
03/11/2010
Last updated
11/25/2020
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