Provider Demographics
NPI:1972831444
Name:MOSES, TWYLA MARIE (PCT)
Entity Type:Individual
Prefix:MRS
First Name:TWYLA
Middle Name:MARIE
Last Name:MOSES
Suffix:
Gender:F
Credentials:PCT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7816 SW 7TH PL
Mailing Address - Street 2:
Mailing Address - City:NORTH LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33068-2223
Mailing Address - Country:US
Mailing Address - Phone:954-586-4577
Mailing Address - Fax:
Practice Address - Street 1:7816 SW 7TH PL
Practice Address - Street 2:
Practice Address - City:NORTH LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33068-2223
Practice Address - Country:US
Practice Address - Phone:954-586-4577
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-21
Last Update Date:2009-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCNA1996053747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant