Provider Demographics
NPI:1629578349
Name:MOSS, TOYIN BRIANA (LVN)
Entity Type:Individual
Prefix:MS
First Name:TOYIN
Middle Name:BRIANA
Last Name:MOSS
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:TOYIN
Other - Middle Name:BRIANA
Other - Last Name:MOSS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LVN
Mailing Address - Street 1:131 DREW AVE
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78220-1016
Mailing Address - Country:US
Mailing Address - Phone:210-317-1430
Mailing Address - Fax:
Practice Address - Street 1:4335 W PIEDRAS DR
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78228-1215
Practice Address - Country:US
Practice Address - Phone:210-731-9570
Practice Address - Fax:210-731-9575
Is Sole Proprietor?:No
Enumeration Date:2018-02-19
Last Update Date:2018-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX224560164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse