Individual
DR. NICOLE MOSLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
12800 MISSISSIPPI PKWY STE B201, CROWN POINT, IN 46307-6902
(219) 663-7000
(219) 663-8621
Mailing address
PO BOX 781076, DETROIT, MI 48278-1076
(317) 528-4800
(317) 865-1479
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
01078091A
IN
207Q00000X
Family Medicine Physician
Primary
94-08383
KS
Other
Enumeration date
06/19/2014
Last updated
08/10/2023
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