Provider Demographics
NPI:1821608712
Name:MOSHER, TALIA ROSE (DNP, APRN)
Entity Type:Individual
Prefix:DR
First Name:TALIA
Middle Name:ROSE
Last Name:MOSHER
Suffix:
Gender:F
Credentials:DNP, APRN
Other - Prefix:
Other - First Name:TALIA
Other - Middle Name:ROSE
Other - Last Name:MASCHINO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2116 NE 7TH TER
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32609-3772
Mailing Address - Country:US
Mailing Address - Phone:352-262-9341
Mailing Address - Fax:
Practice Address - Street 1:410 NE WALDO RD
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32641-5685
Practice Address - Country:US
Practice Address - Phone:352-265-7015
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-05
Last Update Date:2022-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11008230363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily