Provider Demographics
NPI:1679623102
Name:MOSES, SHARON ANN (ARNP)
Entity type:Individual
Prefix:MRS
First Name:SHARON
Middle Name:ANN
Last Name:MOSES
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7009 S OAK RD
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99224-9234
Mailing Address - Country:US
Mailing Address - Phone:509-443-9131
Mailing Address - Fax:509-835-4019
Practice Address - Street 1:6191 WELLPINIT AGENCY LOOP
Practice Address - Street 2:
Practice Address - City:WELLPINIT
Practice Address - State:WA
Practice Address - Zip Code:99040
Practice Address - Country:US
Practice Address - Phone:509-258-4517
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30003825363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAP45925Medicare UPIN