Provider Demographics
NPI:1255860805
Name:MOSLEY, JASMINE JENSINE (NP-C)
Entity Type:Individual
Prefix:
First Name:JASMINE
Middle Name:JENSINE
Last Name:MOSLEY
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:JASMINE
Other - Middle Name:JENSINE
Other - Last Name:BATES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP-C
Mailing Address - Street 1:PO BOX 844658
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-4658
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6684 W ADAMS AVE
Practice Address - Street 2:
Practice Address - City:TEMPLE
Practice Address - State:TX
Practice Address - Zip Code:76502-5632
Practice Address - Country:US
Practice Address - Phone:254-899-4200
Practice Address - Fax:254-899-4205
Is Sole Proprietor?:No
Enumeration Date:2017-06-07
Last Update Date:2022-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP133975363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily