Provider Demographics
NPI:1255173399
Name:MOSELEY, JULIA PAULSON
Entity type:Individual
Prefix:
First Name:JULIA
Middle Name:PAULSON
Last Name:MOSELEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2245 E COUNTRY CLUB DR
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84109-1545
Mailing Address - Country:US
Mailing Address - Phone:303-819-5930
Mailing Address - Fax:
Practice Address - Street 1:2245 E COUNTRY CLUB DR
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84109-1545
Practice Address - Country:US
Practice Address - Phone:303-819-5930
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-10
Last Update Date:2024-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT12321862-3102163WX0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WX0200XNursing Service ProvidersRegistered NurseOncology