Provider Demographics
NPI:1831671643
Name:MOSS, APRYL HAWTHORNE (ARNP)
Entity Type:Individual
Prefix:
First Name:APRYL
Middle Name:HAWTHORNE
Last Name:MOSS
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24502 MALVERN ST
Mailing Address - Street 2:
Mailing Address - City:BROOKSVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:34601-4928
Mailing Address - Country:US
Mailing Address - Phone:813-997-6265
Mailing Address - Fax:
Practice Address - Street 1:15211 CORTEZ BLVD
Practice Address - Street 2:
Practice Address - City:BROOKSVILLE
Practice Address - State:FL
Practice Address - Zip Code:34613-6072
Practice Address - Country:US
Practice Address - Phone:352-345-4565
Practice Address - Fax:352-596-6051
Is Sole Proprietor?:No
Enumeration Date:2018-08-29
Last Update Date:2023-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9334284363LF0000X
FLAPRN9334284363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily