Provider Demographics
NPI:1356698732
Name:MOSLEY, ASIA
Entity type:Individual
Prefix:
First Name:ASIA
Middle Name:
Last Name:MOSLEY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3449 E BRAINARD RD APT 201
Mailing Address - Street 2:
Mailing Address - City:WOODMERE
Mailing Address - State:OH
Mailing Address - Zip Code:44122-7807
Mailing Address - Country:US
Mailing Address - Phone:216-855-2225
Mailing Address - Fax:
Practice Address - Street 1:3449 E BRAINARD RD APT 201
Practice Address - Street 2:
Practice Address - City:WOODMERE
Practice Address - State:OH
Practice Address - Zip Code:44122-7807
Practice Address - Country:US
Practice Address - Phone:216-855-2225
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-06
Last Update Date:2012-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH401251500611376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide