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Individual

JANE GREENFIELD MOSCOE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
P.A.-C.

Contact information

Practice address
100 VETERANS DR, WILMORE, KY 40390-9775
(859) 858-2814
(859) 258-8610
Mailing address
100 VETERANS DR, WILMORE, KY 40390-9775
(859) 858-2814
(859) 258-8610

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA017
KY
363AM0700X
Medical Physician Assistant
PA017
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
37903705
MEDICAID LAB GROUP
KY
01
4000501
MEDICARE LAB GROUP
KY
05
95000170
KY
01
CB5773
RR MEDICARE GROUP
01
P00012192
RR MEDICARE PIN
Enumeration date
09/13/2006
Last updated
08/23/2023
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