Provider Demographics
NPI:1497387443
Name:MOSLEY, BRIANNE REBEKAH (RN)
Entity Type:Individual
Prefix:
First Name:BRIANNE
Middle Name:REBEKAH
Last Name:MOSLEY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:BRIANNE
Other - Middle Name:REBEKAH
Other - Last Name:BELZER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1570 BEXHILL CT
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30043-6691
Mailing Address - Country:US
Mailing Address - Phone:678-468-3559
Mailing Address - Fax:
Practice Address - Street 1:1001 JOHNSON FERRY RD
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30342-1605
Practice Address - Country:US
Practice Address - Phone:404-785-2603
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-07
Last Update Date:2020-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN239298163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse