Provider Demographics
NPI:1457801730
Name:TOCCARA MOSLEY MSN, CRNP, PMHNP-BC LLC
Entity Type:Organization
Organization Name:TOCCARA MOSLEY MSN, CRNP, PMHNP-BC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:TOCCARA
Authorized Official - Middle Name:MONIQUE
Authorized Official - Last Name:MOSLEY
Authorized Official - Suffix:
Authorized Official - Credentials:CRNP
Authorized Official - Phone:443-202-0983
Mailing Address - Street 1:6122 MARLORA RD
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21239-1928
Mailing Address - Country:US
Mailing Address - Phone:443-388-8778
Mailing Address - Fax:
Practice Address - Street 1:305 WASHINGTON AVE
Practice Address - Street 2:SUITE 500
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204-4740
Practice Address - Country:US
Practice Address - Phone:443-202-0983
Practice Address - Fax:410-296-7959
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-10
Last Update Date:2016-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR170588363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty