Provider Demographics
NPI:1861622318
Name:MOSES, BARNITTA LATRICIA (CPNP)
Entity type:Individual
Prefix:MRS
First Name:BARNITTA
Middle Name:LATRICIA
Last Name:MOSES
Suffix:
Gender:F
Credentials:CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:5400 OLD COURT RD STE 300B
Mailing Address - Street 2:
Mailing Address - City:RANDALLSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21133-5100
Mailing Address - Country:US
Mailing Address - Phone:410-521-7337
Mailing Address - Fax:410-521-7377
Practice Address - Street 1:5400 OLD COURT RD STE 300B
Practice Address - Street 2:
Practice Address - City:RANDALLSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21133-5100
Practice Address - Country:US
Practice Address - Phone:410-521-7337
Practice Address - Fax:410-521-7377
Is Sole Proprietor?:No
Enumeration Date:2009-07-17
Last Update Date:2019-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR124631363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics