Provider Demographics
NPI:1407634520
Name:MOSS, JOAN ELIZABETH (RN, MSN)
Entity Type:Individual
Prefix:
First Name:JOAN
Middle Name:ELIZABETH
Last Name:MOSS
Suffix:
Gender:F
Credentials:RN, MSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:355 E PARKWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:FRIENDSWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77546-5760
Mailing Address - Country:US
Mailing Address - Phone:409-939-1123
Mailing Address - Fax:
Practice Address - Street 1:355 E PARKWOOD AVE
Practice Address - Street 2:
Practice Address - City:FRIENDSWOOD
Practice Address - State:TX
Practice Address - Zip Code:77546-5760
Practice Address - Country:US
Practice Address - Phone:409-939-1123
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-19
Last Update Date:2023-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX632563163WW0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WW0101XNursing Service ProvidersRegistered NurseWomen's Health Care, Ambulatory