Moss, Enos Kenneth

Moss, Enos Kenneth is an individual health care provider with primary practice located at 14101 Sullyfield Cir Ste 400A , Chantilly VA 20151-1781. He recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Adult Health, Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health. Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health is his primary health care specialty. Moss, Enos Kenneth can be contacted via phone (888) 478-1882.

Contact Information

Primary practice address
14101 Sullyfield Cir Ste 400A Chantilly VA 20151-1781
Phone: (888) 478-1882
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Adult Health 363LA2200X 2012011952 Missouri
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X 2012011952 Missouri

Profile Details

NPI number 1548527997
LBN Legal business name Moss, Enos Kenneth
Credentials RN, MSN, ANP-BC
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 23rd, 2012
Last updated Mar 17th, 2018 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1548527997 NPPES
Missouri MEDICAID 1548527997

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