Provider Demographics
NPI:1841329166
Name:MOSS, CATHERINE EGEOLU (FNP)
Entity type:Individual
Prefix:MS
First Name:CATHERINE
Middle Name:EGEOLU
Last Name:MOSS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
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Other - Middle Name:
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Mailing Address - Street 1:2790 CLAY EDWARDS DR STE 410
Mailing Address - Street 2:
Mailing Address - City:NORTH KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64116-3274
Mailing Address - Country:US
Mailing Address - Phone:168-474-9353
Mailing Address - Fax:816-747-3627
Practice Address - Street 1:2790 CLAY EDWARDS DR STE 410
Practice Address - Street 2:
Practice Address - City:NORTH KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64116-3274
Practice Address - Country:US
Practice Address - Phone:816-474-9353
Practice Address - Fax:816-474-3627
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-04
Last Update Date:2022-06-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NE3176101YM0800X
MO2020020502363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health