Provider Demographics
NPI:1699781815
Name:MOSLEY, STEVE (LPN)
Entity type:Individual
Prefix:
First Name:STEVE
Middle Name:
Last Name:MOSLEY
Suffix:
Gender:M
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5378 WHIRLWIND COVE DRIVE
Mailing Address - Street 2:
Mailing Address - City:HILLIARD
Mailing Address - State:OH
Mailing Address - Zip Code:43026-8300
Mailing Address - Country:US
Mailing Address - Phone:614-597-7106
Mailing Address - Fax:614-771-8952
Practice Address - Street 1:5378 WHIRLWIND COVE DRIVE
Practice Address - Street 2:
Practice Address - City:HILLIARD
Practice Address - State:OH
Practice Address - Zip Code:43026-8300
Practice Address - Country:US
Practice Address - Phone:614-597-7106
Practice Address - Fax:614-771-8952
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN109779164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse