Provider Demographics
NPI:1336190933
Name:MOSLEY, CARRIE (FNP-C)
Entity type:Individual
Prefix:
First Name:CARRIE
Middle Name:
Last Name:MOSLEY
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3838 SAN DIMAS ST
Mailing Address - Street 2:STE 250
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93301-2284
Mailing Address - Country:US
Mailing Address - Phone:661-321-3161
Mailing Address - Fax:661-321-3166
Practice Address - Street 1:3838 SAN DIMAS ST
Practice Address - Street 2:STE 250
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93301-2284
Practice Address - Country:US
Practice Address - Phone:661-323-5300
Practice Address - Fax:661-323-5455
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-16
Last Update Date:2016-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA557554363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAQ14892Medicare UPIN
CAZZZ30086ZMedicare ID - Type UnspecifiedMEDICARE