Provider Demographics
NPI:1447932082
Name:MOSSBARGER, ALEXANDRIA
Entity type:Individual
Prefix:
First Name:ALEXANDRIA
Middle Name:
Last Name:MOSSBARGER
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 1:3011 SMOKEY HOLLOW RD
Mailing Address - Street 2:
Mailing Address - City:THURMAN
Mailing Address - State:OH
Mailing Address - Zip Code:45685-9723
Mailing Address - Country:US
Mailing Address - Phone:740-577-3158
Mailing Address - Fax:
Practice Address - Street 1:3011 SMOKEY HOLLOW RD
Practice Address - Street 2:
Practice Address - City:THURMAN
Practice Address - State:OH
Practice Address - Zip Code:45685-9723
Practice Address - Country:US
Practice Address - Phone:740-577-3158
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-03
Last Update Date:2023-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant