Provider Demographics
NPI:1295745230
Name:MOSER, MELISSA A (MSN, FNP-C)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:A
Last Name:MOSER
Suffix:
Gender:F
Credentials:MSN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 11503
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37401-2503
Mailing Address - Country:US
Mailing Address - Phone:423-778-3274
Mailing Address - Fax:423-778-2255
Practice Address - Street 1:910 BLACKFORD ST
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37403-1405
Practice Address - Country:US
Practice Address - Phone:423-778-6505
Practice Address - Fax:423-778-3157
Is Sole Proprietor?:No
Enumeration Date:2006-08-09
Last Update Date:2013-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN120060163W00000X
TN12183363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse