Provider Demographics
NPI:1962635961
Name:MOSS, ANGELA MARIE (APN-BC)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:MARIE
Last Name:MOSS
Suffix:
Gender:F
Credentials:APN-BC
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Other - Credentials:
Mailing Address - Street 1:600 S PAULINA ST
Mailing Address - Street 2:RUSH UNIVERSITY COLLEGE OF NURSING, OFFICE 1053D AAC
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60612-3806
Mailing Address - Country:US
Mailing Address - Phone:312-942-3436
Mailing Address - Fax:312-942-6226
Practice Address - Street 1:4330 TRANS WORLD RD
Practice Address - Street 2:FLYING FOOD SERVICES HEALTH CLINIC
Practice Address - City:SCHILLER PARK
Practice Address - State:IL
Practice Address - Zip Code:60176-1707
Practice Address - Country:US
Practice Address - Phone:847-678-6738
Practice Address - Fax:847-678-6748
Is Sole Proprietor?:No
Enumeration Date:2009-08-25
Last Update Date:2009-08-25
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IL209.006488363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health