Individual
MARY NICOLE MOSELEY JAEGER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
571 S FLOYD ST, STE 342, LOUISVILLE, KY 40202-3818
(502) 852-8470
Mailing address
PO BOX 909, LOUISVILLE, KY 40201-0909
(502) 588-0329
(502) 588-0326
Taxonomy
Speciality
Code
Description
License number
State
363LN0005X
Critical Care Neonatal Nurse Practitioner
Primary
1112372
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1112372
NURSE'S LICENSE (RN)
KY
01
—
3005194
APRN
KY
Enumeration date
06/12/2007
Last updated
10/26/2020
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