Provider Demographics
NPI:1740848407
Name:MOSSING, EMILEE ANNE (PA-C)
Entity type:Individual
Prefix:MRS
First Name:EMILEE
Middle Name:ANNE
Last Name:MOSSING
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:EMILEE
Other - Middle Name:ANNE
Other - Last Name:PETRUS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:286 ASHBROOK DR
Mailing Address - Street 2:
Mailing Address - City:MARTINEZ
Mailing Address - State:GA
Mailing Address - Zip Code:30907-8856
Mailing Address - Country:US
Mailing Address - Phone:216-990-4848
Mailing Address - Fax:
Practice Address - Street 1:1467 HARPER ST
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30901-2600
Practice Address - Country:US
Practice Address - Phone:706-721-2198
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-29
Last Update Date:2019-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant