Provider Demographics
NPI:1558556886
Name:MOOS, ABIGAIL MARIE (PA)
Entity Type:Individual
Prefix:MS
First Name:ABIGAIL
Middle Name:MARIE
Last Name:MOOS
Suffix:
Gender:F
Credentials:PA
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Mailing Address - Street 1:5701 W 119TH ST
Mailing Address - Street 2:SUITE 430
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66209-3721
Mailing Address - Country:US
Mailing Address - Phone:913-253-3084
Mailing Address - Fax:913-663-2980
Practice Address - Street 1:5701 W 119TH ST
Practice Address - Street 2:SUITE 430
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66209-3721
Practice Address - Country:US
Practice Address - Phone:913-253-3084
Practice Address - Fax:913-663-2980
Is Sole Proprietor?:No
Enumeration Date:2007-09-10
Last Update Date:2022-02-10
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Provider Licenses
StateLicense IDTaxonomies
KST01493363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical