Provider Demographics
NPI:1538573324
Name:MOSE, DAMARIS (MSN-FNP)
Entity type:Individual
Prefix:DR
First Name:DAMARIS
Middle Name:
Last Name:MOSE
Suffix:
Gender:F
Credentials:MSN-FNP
Other - Prefix:
Other - First Name:DAMARIS
Other - Middle Name:G
Other - Last Name:KASIMU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DNP MSN FNP-BC
Mailing Address - Street 1:8025 BLACK HORSE PIKE STE 501
Mailing Address - Street 2:
Mailing Address - City:PLEASANTVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08232-2967
Mailing Address - Country:US
Mailing Address - Phone:844-929-0225
Mailing Address - Fax:609-822-7980
Practice Address - Street 1:486 NORRISTOWN RD STE 133B
Practice Address - Street 2:
Practice Address - City:BLUE BELL
Practice Address - State:PA
Practice Address - Zip Code:19422-2353
Practice Address - Country:US
Practice Address - Phone:844-929-0225
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-19
Last Update Date:2024-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DELG-0000750363LF0000X
PASP016192363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily