Individual
MRS. JENNIFER MOSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
3100 OAK GROVE RD, POPLAR BLUFF, MO 63901-1573
(573) 785-7721
Mailing address
2946 W LAKEVIEW DR, POPLAR BLUFF, MO 63901-9740
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
2015016109
MO
Other
Enumeration date
03/30/2015
Last updated
05/29/2015
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