Provider Demographics
NPI:1609675008
Name:MOSHIER, GIDGETTE R
Entity type:Individual
Prefix:
First Name:GIDGETTE
Middle Name:R
Last Name:MOSHIER
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 10543
Mailing Address - Street 2:
Mailing Address - City:PRESCOTT
Mailing Address - State:AZ
Mailing Address - Zip Code:86304-0543
Mailing Address - Country:US
Mailing Address - Phone:480-220-4892
Mailing Address - Fax:
Practice Address - Street 1:887 GOLDEN HAWK DR
Practice Address - Street 2:
Practice Address - City:PRESCOTT
Practice Address - State:AZ
Practice Address - Zip Code:86301-4665
Practice Address - Country:US
Practice Address - Phone:480-220-4892
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-10
Last Update Date:2025-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator