Provider Demographics
NPI:1588053565
Name:MOSLEY, SHEENA LYNN (APRN)
Entity type:Individual
Prefix:
First Name:SHEENA
Middle Name:LYNN
Last Name:MOSLEY
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1709 KY ROUTE 321
Mailing Address - Street 2:SUITE 3
Mailing Address - City:PRESTONSBURG
Mailing Address - State:KY
Mailing Address - Zip Code:41653-9097
Mailing Address - Country:US
Mailing Address - Phone:606-886-8546
Mailing Address - Fax:606-886-8548
Practice Address - Street 1:1709 KY ROUTE 321
Practice Address - Street 2:SUITE 3
Practice Address - City:PRESTONSBURG
Practice Address - State:KY
Practice Address - Zip Code:41653-9097
Practice Address - Country:US
Practice Address - Phone:606-886-8546
Practice Address - Fax:606-886-8548
Is Sole Proprietor?:No
Enumeration Date:2015-01-14
Last Update Date:2020-10-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY3009164363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY3009164OtherAPRN LICENSE