Kelsey-jo Audrey Moss
Kelsey-jo Audrey Hodges · Nurse Practitioner (Pediatrics)

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 Identifier (NPI) 1477197705
Entity Type Individual
Full Name Kelsey-jo Audrey Moss
Other Name Kelsey-jo Audrey Hodges
Credential CPNP-PC
Gender Female
Practice Address 704b Ne 62nd Ave
Portland
OR 97213-4351
Practice Telephone 9714007350
Mailing Address 704b Ne 62nd Ave
Portland
OR 97213-4351
Mailing Telephone 9714007350
Sole Proprietor No, this individual is not a Sole Proprietor
Enumeration Date 2019-10-30
Last Update Date 2019-10-30

Taxonomy Codes

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

Taxonomy Information

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

Taxonomy Definition

Definition to come...

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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
1912050360 Shannon Kathleen Anastasiadis Nurse Practitioner 619 Nw 6th Ave, Portland, OR 97209-3964 2007-01-19
1053320804 Karen Elizabeth Caines Nurse Practitioner 96 Falmouth St, Portland, ME 04104-9300 2006-08-07
1316940398 Janie Lou Huff Nurse Practitioner 3507 Se 36th Ave, Portland, OR 97202-1862 2005-05-24
1518502160 Brandy Lynn Crowson Nurse Practitioner 277 Buddy Ganem Dr Ste A, Portland, TX 78374-3202 2019-11-07
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Office Location

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

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1801431218 Denise Dorgan-miller Occupational Therapy Assistant Providence Elder Place, 4400 Ne Halsey Suite 200, Portland, OR 97213 2019-11-08
1093359283 Kristine Melissa Butler Registered Nurse 6524 Ne Alameda St., Portland, OR 97213 2019-10-31
1619435617 Aspiration of Character Counseling Services, LLC Counselor 4424 Ne Glisan St, The Li Wellness Building, Second Floor, Portland, OR 97213 2019-03-08
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
1770094260 Rachel Wysocki Chiropractor 1619 Ne 42nd Ave, Portland, OR 97213 2017-10-24
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
1891155677 Carissa Marie St. Onge Carneiro Advanced Practice Midwife 545 Ne 47th Ave Ste 102, Portland, OR 97213 2016-03-07
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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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