Individual
TIFFANY CHARON MOSBY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
508 FULTON STREET, DURHAM VA MEDICAL CENTER, DURHAM, NC 27700
(919) 416-8001
(919) 286-6875
Mailing address
911 2ND ST, MOUNDS, IL 62964-1344
(757) 234-1923
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
0002075837
VA
Other
Enumeration date
08/13/2009
Last updated
08/13/2009
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