Individual
MRS. LISA RENEE MOSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM
Contact information
Practice address
2 TAMPA GENERAL CIR, TAMPA, FL 33606-3571
(813) 974-2201
(813) 974-4325
Mailing address
PO BOX 917770, ORLANDO, FL 32891-0001
(813) 974-2201
(813) 974-4325
Taxonomy
Speciality
Code
Description
License number
State
367A00000X
Advanced Practice Midwife
Primary
ARNP9345389
FL
367A00000X
Advanced Practice Midwife
MW010145
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
024261100
—
FL
01
—
Y0F1N
BLUE CROSS BLUE SHIELD
FL
Enumeration date
02/28/2007
Last updated
05/17/2021
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