Provider Demographics
NPI:1710327192
Name:MOSLEY, SHALINA NICHOLE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:SHALINA
Middle Name:NICHOLE
Last Name:MOSLEY
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:256 COUNTY ROAD 1158
Mailing Address - Street 2:
Mailing Address - City:CULLMAN
Mailing Address - State:AL
Mailing Address - Zip Code:35057-0829
Mailing Address - Country:US
Mailing Address - Phone:256-962-1065
Mailing Address - Fax:
Practice Address - Street 1:444 2ND AVE NW
Practice Address - Street 2:
Practice Address - City:CULLMAN
Practice Address - State:AL
Practice Address - Zip Code:35055-2811
Practice Address - Country:US
Practice Address - Phone:256-736-9901
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-28
Last Update Date:2013-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL17369183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist