KELSEY-JO AUDREY MOSS


Address: 704b Ne 62nd Ave, Portland, OR 97213-4351
Phone: 9714007350

KELSEY-JO AUDREY MOSS (NPI# 1477197705) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1477197705
Entity Type Individual
Full Name KELSEY-JO AUDREY MOSS
Other Name KELSEY-JO AUDREY HODGES
Credential CPNP-PC
Practice Address 704b Ne 62nd Ave
Portland
OR 97213-4351
Practice Telephone 9714007350
Mailing Telephone 9714007350
Enumeration Date 2019-10-30
Last Update Date 2019-10-30
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363LP0200X Nurse Practitioner
Specialization: Pediatrics
201907307NP-PP OR Physician Assistants & Advanced Practice Nursing Providers

Office Location

Street Address 704B NE 62ND AVE
City PORTLAND
State OR
Zip Code 97213-4351

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1578049631 Credena Health LLC Pharmacy 4805 Ne Glisan St Ste 11n321, Portland, OR 97213 2018-07-12
1023507795 Karissa Lynn Schwartz Speech-Language Pathologist Providence Portland Medical Center, 4805 Ne Glisan St, Portland, OR 97213 2018-05-08
1861944506 James Livingston Taylor Chiropractor 5212 Ne Sacremento St., Portland, OR 97213 2016-10-28
1962958520 Caitlin Turner Massage Therapist 4317 Ne Tillamook St., Portland, OR 97213 2016-09-01
1326407008 Julianna Vermeys Counselor 4605 Ne Fremont St., 209a, Portland, OR 97213 2016-02-23
1881059822 Thomas Michael Barrett Counselor 5228 Ne Hoyt St. Bldg. B, Portland, OR 97213 2015-12-17
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Taxonomy Information

Taxonomy Code 363LP0200X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Pediatrics

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1063054716 Lori P Balchik Nurse Practitioner 277 Buddy Ganem Dr Ste A, Portland, TX 78374-3202 2019-10-15
1295273399 Shaudine Woody Nurse Practitioner 11790 Sw Barnes Rd Ste 140, Portland, OR 97225-5938 2017-02-08
1003239120 Iva Juric Nurse Practitioner 3181 Sw Sam Jackson Park Rd # Cdw6, Portland, OR 97239-3011 2014-01-24
1811249592 Pollee Hruby Brookings Nurse Practitioner 3181 Sw Sam Jackson Park Rd # Cdw7, Portland, OR 97239-3098 2012-10-05
1033470646 Chelsea Doherty Nurse Practitioner 14480 Sw 90th Ave, Portland, OR 97224 2012-05-31
1265699508 Mallory Johnson Nurse Practitioner 11790 Sw Barnes Rd. Blg A, Ste 140, Portland, OR 97225 2008-05-22
1053320804 Karen Elizabeth Caines Nurse Practitioner 96 Falmouth St, Portland, ME 04104-9300 2006-08-07
1649209982 Joanne M Perry Nurse Practitioner 901 Washington Ave Ste 100, Portland, ME 04103-2842 2006-06-30
1497377220 Erika Lynn Rodakowski Nurse Practitioner 3181 Sw Sam Jackson Park Rd, Portland, OR 97239-3011 2020-05-14
1518502160 Brandy Lynn Crowson Nurse Practitioner 277 Buddy Ganem Dr Ste A, Portland, TX 78374-3202 2019-11-07
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Competitor

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City PORTLAND
Zip Code 97213

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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