Provider Demographics
NPI:1932948064
Name:MOSLEY, TYNIKA MESHELL
Entity type:Individual
Prefix:
First Name:TYNIKA
Middle Name:MESHELL
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 1:31144 BOWERY CT
Mailing Address - Street 2:
Mailing Address - City:MENIFEE
Mailing Address - State:CA
Mailing Address - Zip Code:92584-3201
Mailing Address - Country:US
Mailing Address - Phone:951-627-0236
Mailing Address - Fax:
Practice Address - Street 1:31144 BOWERY CT
Practice Address - Street 2:
Practice Address - City:MENIFEE
Practice Address - State:CA
Practice Address - Zip Code:92584-3201
Practice Address - Country:US
Practice Address - Phone:951-627-0236
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-20
Last Update Date:2024-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care ProviderGroup - Single Specialty