Individual
SUSAN MOSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
165 CORPORATE DR, HOUMA, LA 70360-2767
(985) 851-1001
(985) 851-1071
Mailing address
801 N GRAND AVE, STE 1, GAINESVILLE, TX 76240-3574
(985) 851-1001
(985) 851-1071
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
080012
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1449172
—
LA
05
—
99322
—
LA
Enumeration date
10/17/2006
Last updated
04/25/2017
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