Provider Demographics
NPI:1699138172
Name:MOSLEY, DIAN
Entity type:Individual
Prefix:
First Name:DIAN
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 1:1108 GLENFIDDICH DR
Mailing Address - Street 2:APT G
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28215
Mailing Address - Country:US
Mailing Address - Phone:704-837-6628
Mailing Address - Fax:864-242-0700
Practice Address - Street 1:2320 E NORTH ST
Practice Address - Street 2:DD-103
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29607-1247
Practice Address - Country:US
Practice Address - Phone:864-239-6900
Practice Address - Fax:864-242-0700
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-01
Last Update Date:2016-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
No372500000XNursing Service Related ProvidersChore Provider
No372600000XNursing Service Related ProvidersAdult Companion
No376J00000XNursing Service Related ProvidersHomemaker
No376K00000XNursing Service Related ProvidersNurse's Aide