Provider Demographics
NPI:1053471334
Name:MOSIER, CAROLYN O'LEARY (RN)
Entity type:Individual
Prefix:
First Name:CAROLYN
Middle Name:O'LEARY
Last Name:MOSIER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6440 OVERBROOK ST
Mailing Address - Street 2:
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22043-1944
Mailing Address - Country:US
Mailing Address - Phone:703-599-9180
Mailing Address - Fax:
Practice Address - Street 1:6440 OVERBROOK ST
Practice Address - Street 2:
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22043-1944
Practice Address - Country:US
Practice Address - Phone:703-599-9180
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-09
Last Update Date:2025-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001168291163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation ConsultantGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
Q59561Medicare UPIN