Individual
JEANNINE M. MOSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
5855 BREMO RD, SUITE 506, RICHMOND, VA 23226-1926
(804) 285-3225
(804) 285-0360
Mailing address
5855 BREMO RD, SUITE 506, RICHMOND, VA 23226-1926
(804) 285-3225
(804) 285-0360
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
0017137123
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C06695
GROUP PTAN
VA
Enumeration date
04/26/2007
Last updated
03/12/2012
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