Provider Demographics
NPI:1316314537
Name:MOSLEY, MARIS
Entity type:Individual
Prefix:
First Name:MARIS
Middle Name:
Last Name:MOSLEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1330 POWELL ST
Mailing Address - Street 2:SUITE 507
Mailing Address - City:NORRISTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19401-3353
Mailing Address - Country:US
Mailing Address - Phone:484-622-7300
Mailing Address - Fax:484-622-7310
Practice Address - Street 1:1330 POWELL ST
Practice Address - Street 2:SUITE 507
Practice Address - City:NORRISTOWN
Practice Address - State:PA
Practice Address - Zip Code:19401-3353
Practice Address - Country:US
Practice Address - Phone:484-622-7300
Practice Address - Fax:484-622-7310
Is Sole Proprietor?:No
Enumeration Date:2015-08-24
Last Update Date:2016-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DELH-0000213363LW0102X
PASP016005363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health