Provider Demographics
NPI:1407943061
Name:MOSES, SHARMAN TYBRING (MS RN CS APRN)
Entity Type:Individual
Prefix:MS
First Name:SHARMAN
Middle Name:TYBRING
Last Name:MOSES
Suffix:
Gender:F
Credentials:MS RN CS APRN
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Mailing Address - Street 1:3 COLT LANE
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02360
Mailing Address - Country:US
Mailing Address - Phone:508-833-2782
Mailing Address - Fax:508-563-2262
Practice Address - Street 1:200 TER HEUN DR
Practice Address - Street 2:GOSNOLD THORNE COUNSELING CTR
Practice Address - City:FALMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02540
Practice Address - Country:US
Practice Address - Phone:508-563-2262
Practice Address - Fax:508-563-2660
Is Sole Proprietor?:No
Enumeration Date:2006-10-06
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA163695PC364SP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0809XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Adult
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA006404OtherHPHC
MA163695OtherTUFTS HEALTH PLAN
PN041963Medicare UPIN
MA006404OtherHPHC