Individual
GRACE MARIE MOSES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
740 S LIMESTONE STE L119, LEXINGTON, KY 40536-0001
(859) 257-3253
(859) 323-1203
Mailing address
900 S LIMESTONE, LEXINGTON, KY 40536-0001
(606) 524-6828
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA3309
KY
363A00000X
Physician Assistant
TC049
KY
363AM0700X
Medical Physician Assistant
PA3309
KY
363AM0700X
Medical Physician Assistant
TC049
KY
363AS0400X
Surgical Physician Assistant
PA3309
KY
363AS0400X
Surgical Physician Assistant
TC049
KY
Other
Enumeration date
06/08/2023
Last updated
01/10/2024
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