Provider Demographics
NPI:1669046595
Name:MOSIER MOSLEY, JANAE
Entity type:Individual
Prefix:
First Name:JANAE
Middle Name:
Last Name:MOSIER MOSLEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JANAE
Other - Middle Name:
Other - Last Name:MOSIER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8304 FEATHER DUSTER CT
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89113-1754
Mailing Address - Country:US
Mailing Address - Phone:702-917-3987
Mailing Address - Fax:
Practice Address - Street 1:2715 E RUSSELL RD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89120-2426
Practice Address - Country:US
Practice Address - Phone:702-848-1696
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-15
Last Update Date:2021-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner