Basic Information
| Provider Information | |||||||||
| NPI: | 1265071070 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MOSLEY | ||||||||
| FirstName: | SALINA | ||||||||
| MiddleName: | REANEE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2460 W 26TH AVE STE 217 | ||||||||
| Address2: | |||||||||
| City: | DENVER | ||||||||
| State: | CO | ||||||||
| PostalCode: | 802115308 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3033227108 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1920 E 13TH AVE | ||||||||
| Address2: | |||||||||
| City: | DENVER | ||||||||
| State: | CO | ||||||||
| PostalCode: | 802062002 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3033212482 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 12/26/2019 | ||||||||
| LastUpdateDate: | 12/26/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 12/26/2019 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 376K00000X | NA00783472 | CO | Y | Nursing Service Related Providers | Nurse's Aide |
No ID Information.