Provider Demographics
NPI:1114713997
Name:MOSLEY, TALIYAH R (NA)
Entity type:Individual
Prefix:
First Name:TALIYAH
Middle Name:R
Last Name:MOSLEY
Suffix:
Gender:
Credentials:NA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3417 N 29TH CIR
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68111-3276
Mailing Address - Country:US
Mailing Address - Phone:402-215-4948
Mailing Address - Fax:
Practice Address - Street 1:11011 Q ST STE C11011Q
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68137-3700
Practice Address - Country:US
Practice Address - Phone:402-697-5121
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-17
Last Update Date:2025-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE372500000X, 372600000X, 3747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No372500000XNursing Service Related ProvidersChore Provider
No372600000XNursing Service Related ProvidersAdult Companion