Provider Demographics
NPI:1326751561
Name:MOSER, KASHEA DAYASMIN (PMHNP)
Entity Type:Individual
Prefix:
First Name:KASHEA
Middle Name:DAYASMIN
Last Name:MOSER
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2836 HORSESHOE BEND RD
Mailing Address - Street 2:
Mailing Address - City:RANDLEMAN
Mailing Address - State:NC
Mailing Address - Zip Code:27317-8211
Mailing Address - Country:US
Mailing Address - Phone:336-953-0157
Mailing Address - Fax:
Practice Address - Street 1:445 DOLLEY MADISON RD STE 100
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27410-5166
Practice Address - Country:US
Practice Address - Phone:336-649-9000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-03
Last Update Date:2023-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC288808163WP0808X
NC5017592363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health