Provider Demographics
NPI:1598421349
Name:MOSHER, ISABEL (APRN)
Entity Type:Individual
Prefix:
First Name:ISABEL
Middle Name:
Last Name:MOSHER
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 QUARRY HILLS DR APT 1421
Mailing Address - Street 2:
Mailing Address - City:QUINCY
Mailing Address - State:MA
Mailing Address - Zip Code:02169-3853
Mailing Address - Country:US
Mailing Address - Phone:203-654-6541
Mailing Address - Fax:
Practice Address - Street 1:200 QUARRY HILLS DR APT 1421
Practice Address - Street 2:
Practice Address - City:QUINCY
Practice Address - State:MA
Practice Address - Zip Code:02169-3853
Practice Address - Country:US
Practice Address - Phone:203-654-6541
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-16
Last Update Date:2024-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2312396163W00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse