Provider Demographics
NPI:1114408168
Name:MOSELEY, RACHEL M
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:M
Last Name:MOSELEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:420 TAYLOR ST NE APT 13C
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20017-1542
Mailing Address - Country:US
Mailing Address - Phone:202-531-1438
Mailing Address - Fax:
Practice Address - Street 1:1111 MASSACHUSETTS AVE NW APT 314
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20005-4621
Practice Address - Country:US
Practice Address - Phone:202-956-8173
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-28
Last Update Date:2018-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC700-19068Medicaid