Basic Information
| Provider Information | |||||||||
| NPI: | 1104293679 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MOSLEY | ||||||||
| FirstName: | JOSHUA | ||||||||
| MiddleName: | W | ||||||||
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| Credential: | F.N.P. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 701 N STATE OF FRANKLIN RD | ||||||||
| Address2: | SUITE 2 | ||||||||
| City: | JOHNSON CITY | ||||||||
| State: | TN | ||||||||
| PostalCode: | 376043645 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4239264468 | ||||||||
| FaxNumber: | 4239284838 | ||||||||
| Practice Location | |||||||||
| Address1: | 701 N STATE OF FRANKLIN RD | ||||||||
| Address2: | SUITE 2 | ||||||||
| City: | JOHNSON CITY | ||||||||
| State: | TN | ||||||||
| PostalCode: | 376043645 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4239264468 | ||||||||
| FaxNumber: | 4239284838 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/31/2015 | ||||||||
| LastUpdateDate: | 04/28/2017 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | APN0000020335 | TN | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.