Provider Demographics
NPI:1053124396
Name:MOSLEY, CATHERINE ELIZABETH (FNP-C)
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:ELIZABETH
Last Name:MOSLEY
Suffix:
Gender:
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:648 LEXINGTON DR
Mailing Address - Street 2:
Mailing Address - City:CHICAGO HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60411-1907
Mailing Address - Country:US
Mailing Address - Phone:708-491-0083
Mailing Address - Fax:
Practice Address - Street 1:648 LEXINGTON DR
Practice Address - Street 2:
Practice Address - City:CHICAGO HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60411-1907
Practice Address - Country:US
Practice Address - Phone:708-491-0083
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-30
Last Update Date:2025-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209031983363LF0000X
IL041508503163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse