Provider Demographics
NPI:1215094453
Name:MOSER, KIMBERLY EVANS (MA)
Entity type:Individual
Prefix:MRS
First Name:KIMBERLY
Middle Name:EVANS
Last Name:MOSER
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5405 LABRADOR DR
Mailing Address - Street 2:
Mailing Address - City:HOPE MILLS
Mailing Address - State:NC
Mailing Address - Zip Code:28348-9247
Mailing Address - Country:US
Mailing Address - Phone:910-323-9521
Mailing Address - Fax:910-907-8912
Practice Address - Street 1:4861 LOGISTICS ST
Practice Address - Street 2:
Practice Address - City:FORT LIBERTY
Practice Address - State:NC
Practice Address - Zip Code:28310-7301
Practice Address - Country:US
Practice Address - Phone:910-907-6649
Practice Address - Fax:910-907-8912
Is Sole Proprietor?:No
Enumeration Date:2007-01-03
Last Update Date:2024-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist