Provider Demographics
NPI:1457424061
Name:LEE-MOSIER, JEAN LAVONA (FNP)
Entity Type:Individual
Prefix:MS
First Name:JEAN
Middle Name:LAVONA
Last Name:LEE-MOSIER
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:JEAN
Other - Middle Name:L
Other - Last Name:LEE-MOSIER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:40 FRANKLIN ST
Mailing Address - Street 2:SUITE 1 FAMILY PRACTICE ASSOCIATES PC
Mailing Address - City:CARTHAGE
Mailing Address - State:NY
Mailing Address - Zip Code:13619-1323
Mailing Address - Country:US
Mailing Address - Phone:315-493-7334
Mailing Address - Fax:315-493-4232
Practice Address - Street 1:40 FRANKLIN ST
Practice Address - Street 2:SUITE 1 FAMILY PRACTICE ASSOCIATES PC
Practice Address - City:CARTHAGE
Practice Address - State:NY
Practice Address - Zip Code:13619-1323
Practice Address - Country:US
Practice Address - Phone:315-493-7334
Practice Address - Fax:315-493-4232
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2008-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF300489363LF0000X
NYF3304891363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily