Individual
MS. SANDRA A MOSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
1015 CHESTNUT ST STE 1321, PHILADELPHIA, PA 19107-4313
(215) 955-8435
(215) 955-2342
Mailing address
1015 CHESTNUT ST STE 1321, PHILADELPHIA, PA 19107-4313
(215) 955-9854
(215) 955-2342
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
SP007945
PA
363LP0200X
Pediatric Nurse Practitioner
VP005103D
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
23209585
—
PA
01
—
232809585
HEMATOLOGY
PA
Enumeration date
06/05/2017
Last updated
06/05/2017
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