Individual
CAROLINE MOSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP
Contact information
Practice address
5621 SLEEPY CREEK LN, FORT WORTH, TX 76179-7615
(817) 412-8521
Mailing address
5621 SLEEPY CREEK LN, FORT WORTH, TX 76179-7615
(817) 412-8521
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
AP129874
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
120160415000607
MEDICAID
—
01
—
8497NV
BCBS
TX
Enumeration date
02/22/2016
Last updated
10/24/2023
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