Provider Demographics
NPI:1538205075
Name:MOSKOWITE, MARY ELLEN (RN PHN)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:ELLEN
Last Name:MOSKOWITE
Suffix:
Gender:F
Credentials:RN PHN
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Mailing Address - Street 1:2344 OLD SONOMA RD
Mailing Address - Street 2:BUILDING B
Mailing Address - City:NAPA
Mailing Address - State:CA
Mailing Address - Zip Code:94559-3708
Mailing Address - Country:US
Mailing Address - Phone:707-253-4816
Mailing Address - Fax:707-299-4479
Practice Address - Street 1:2344 OLD SONOMA RD
Practice Address - Street 2:BUILDING B
Practice Address - City:NAPA
Practice Address - State:CA
Practice Address - Zip Code:94559-3708
Practice Address - Country:US
Practice Address - Phone:707-253-4816
Practice Address - Fax:707-299-4479
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-30
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CA309584163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health