Provider Demographics
NPI:1336175900
Name:MOSELEY, BARBARA ANN (CNP)
Entity Type:Individual
Prefix:MRS
First Name:BARBARA
Middle Name:ANN
Last Name:MOSELEY
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:BARBARA
Other - Middle Name:ANN
Other - Last Name:CROSBY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CNP
Mailing Address - Street 1:3619 PARK EAST DR STE 109
Mailing Address - Street 2:
Mailing Address - City:BEACHWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44122-4312
Mailing Address - Country:US
Mailing Address - Phone:216-464-6210
Mailing Address - Fax:216-464-6212
Practice Address - Street 1:3619 PARK EAST DR STE 109
Practice Address - Street 2:
Practice Address - City:BEACHWOOD
Practice Address - State:OH
Practice Address - Zip Code:44122-4312
Practice Address - Country:US
Practice Address - Phone:216-464-6210
Practice Address - Fax:216-464-6212
Is Sole Proprietor?:No
Enumeration Date:2006-06-24
Last Update Date:2020-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03791363LA2200X, 363LG0600X
OHNP-03791363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2361564Medicaid
OH9114116OtherAETNA
OH000000233293OtherUNISON
OH000000552366OtherANTHEM
OHMONP11682Medicare PIN
OH2361564Medicaid