Provider Demographics
NPI:1962867127
Name:MOSLEY, JESSICA (FNP)
Entity Type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:
Last Name:MOSLEY
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5392
Mailing Address - Street 2:
Mailing Address - City:MERIDIAN
Mailing Address - State:MS
Mailing Address - Zip Code:39302-5392
Mailing Address - Country:US
Mailing Address - Phone:601-213-3010
Mailing Address - Fax:601-213-3011
Practice Address - Street 1:1221 N WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:LIVINGSTON
Practice Address - State:AL
Practice Address - Zip Code:35470-5410
Practice Address - Country:US
Practice Address - Phone:205-652-9575
Practice Address - Fax:205-652-7979
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-15
Last Update Date:2023-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-132217163W00000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse