Provider Demographics
NPI:1790419554
Name:MOSES, FALISHA (RN)
Entity Type:Individual
Prefix:
First Name:FALISHA
Middle Name:
Last Name:MOSES
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:FALISHA
Other - Middle Name:
Other - Last Name:MOSES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN
Mailing Address - Street 1:1115 HIGHLAND PARK DR
Mailing Address - Street 2:
Mailing Address - City:NATCHITOCHES
Mailing Address - State:LA
Mailing Address - Zip Code:71457-4852
Mailing Address - Country:US
Mailing Address - Phone:318-378-8990
Mailing Address - Fax:
Practice Address - Street 1:1115 HIGHLAND PARK DR
Practice Address - Street 2:
Practice Address - City:NATCHITOCHES
Practice Address - State:LA
Practice Address - Zip Code:71457-4852
Practice Address - Country:US
Practice Address - Phone:318-379-8990
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-15
Last Update Date:2022-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA201083163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse