Individual
KELLI ANN MOSHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
713-B S FAYETTEVILLE STREET, ASHEBORO, NC 27203
(336) 626-0033
Mailing address
PO BOX 14878, GREENSBORO, NC 27415
(336) 626-0033
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
103547
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C7336
MEDCOST
NC
01
—
P00033893
RAILROAD MEDICARE
NC
Enumeration date
05/01/2007
Last updated
07/08/2007
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