Individual
MR. CONNELL MOSLEY SR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
966 MAPLE CREEK DR, SLIDELL, LA 70461-5340
(904) 434-1356
Mailing address
966 MAPLE CREEK DR, SLIDELL, LA 70461-5340
(904) 434-1356
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
164W00000X
Licensed Practical Nurse
Primary
20162552
LA
174H00000X
Health Educator
—
—
372600000X
Adult Companion
—
—
376J00000X
Homemaker
—
—
Other
Enumeration date
09/25/2018
Last updated
09/27/2018
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