Provider Demographics
NPI:1497908933
Name:MOSS, LISA S (NP)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:S
Last Name:MOSS
Suffix:
Gender:F
Credentials:NP
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Mailing Address - Street 1:PO BOX 91734
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23291-1734
Mailing Address - Country:US
Mailing Address - Phone:804-358-6100
Mailing Address - Fax:804-342-7619
Practice Address - Street 1:1250 E MARSHALL ST
Practice Address - Street 2:DEPT. OF INTERNAL MEDICINE-HEMATOLOGY/ONCOLOGY
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23298-5051
Practice Address - Country:US
Practice Address - Phone:434-447-3151
Practice Address - Fax:434-774-2446
Is Sole Proprietor?:No
Enumeration Date:2008-10-28
Last Update Date:2014-07-29
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Provider Licenses
StateLicense IDTaxonomies
VA0024168033363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health