Provider Demographics
NPI:1467834432
Name:MOSER, LAUREN (MA)
Entity Type:Individual
Prefix:MRS
First Name:LAUREN
Middle Name:
Last Name:MOSER
Suffix:
Gender:F
Credentials:MA
Other - Prefix:MS
Other - First Name:LAUREN
Other - Middle Name:
Other - Last Name:BARGER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MA
Mailing Address - Street 1:344 E 100 S
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84111-1700
Mailing Address - Country:US
Mailing Address - Phone:832-451-0239
Mailing Address - Fax:
Practice Address - Street 1:344 E 100 S
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84111-1700
Practice Address - Country:US
Practice Address - Phone:832-451-0239
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-25
Last Update Date:2021-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA10044943376K00000X
TX8608534376K00000X
CONA.00762177376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
CONA.00762177OtherCNA CERTIFICATION
TX8608534OtherCNA CERTIFICATION
PA10044943OtherCNA CERTIFICATION