Provider Demographics
NPI:1871991257
Name:MOYER, ROSEMARY (CRNP)
Entity type:Individual
Prefix:
First Name:ROSEMARY
Middle Name:
Last Name:MOYER
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 N LEWISBERRY RD
Mailing Address - Street 2:
Mailing Address - City:DILLSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17019-9537
Mailing Address - Country:US
Mailing Address - Phone:717-571-9077
Mailing Address - Fax:
Practice Address - Street 1:106 N LEWISBERRY RD
Practice Address - Street 2:
Practice Address - City:DILLSBURG
Practice Address - State:PA
Practice Address - Zip Code:17019-9537
Practice Address - Country:US
Practice Address - Phone:717-571-9077
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-17
Last Update Date:2014-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAVP-005668-C363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health