Provider Demographics
NPI:1316053655
Name:MOSS, KRISTINA M (NP)
Entity type:Individual
Prefix:MRS
First Name:KRISTINA
Middle Name:M
Last Name:MOSS
Suffix:
Gender:F
Credentials:NP
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Mailing Address - Street 1:550 LATONA RD
Mailing Address - Street 2:BLDG D STE 411
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14626-2700
Mailing Address - Country:US
Mailing Address - Phone:585-471-5799
Mailing Address - Fax:585-471-5799
Practice Address - Street 1:550 LATONA RD
Practice Address - Street 2:BLDG D STE 411
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14626-2700
Practice Address - Country:US
Practice Address - Phone:585-471-5799
Practice Address - Fax:585-471-5799
Is Sole Proprietor?:No
Enumeration Date:2006-08-21
Last Update Date:2016-03-02
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NYF400791363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health