Provider Demographics
NPI:1932455698
Name:MOSELY, ELVIRA (RN)
Entity type:Individual
Prefix:
First Name:ELVIRA
Middle Name:
Last Name:MOSELY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 N CENTRAL AVE
Mailing Address - Street 2:SUITE 606
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85004-4424
Mailing Address - Country:US
Mailing Address - Phone:602-364-5288
Mailing Address - Fax:
Practice Address - Street 1:40 N CENTRAL AVE
Practice Address - Street 2:SUITE 606
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85004-4424
Practice Address - Country:US
Practice Address - Phone:602-364-5288
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-31
Last Update Date:2013-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN153681163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse