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Individual

TONYA LEIGH MOSES

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNP

Contact information

Practice address
1906 GLENN BLVD SW STE 100A, FORT PAYNE, AL 35968-3546
(256) 997-5900
Mailing address
1906 GLENN BLVD SW STE 100A, FORT PAYNE, AL 35968-3546
(256) 997-5900

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
1072400
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
051500695
BLUE CROSS BLUE SHIELD
AL
01
051500696
BLUE CROSS BLUE SHIELD
AL
01
051500697
BLUE CROSS BLUE SHIELD
AL
05
051500700
AL
01
051500703
BLUE CROSS BLUE SHIELD
AL
01
051500704
BLUE CROSS BLUE SHIELD
AL
05
155232
AL
05
161381
AL
01
511-40864
BCBS LOCATION ID
AL
05
630302031
AL
05
630303031
AL
05
630306031
AL
05
630307031
AL
05
630308031
AL
05
630309031
AL
01
P00212471
MEDICARE RAILROAD RETIREM
AL
Enumeration date
01/15/2007
Last updated
09/29/2014
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