Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mrs. Jaclyn Iris Moss, FNPB-C

Individual provider Family Nurse Practitioner · NPI 1568791259

Mrs. Jaclyn Iris Moss, FNPB-C is a Nurse Practitioner in Memphis, Tennessee. Qualified in 2008, 18 years ago. Practices with Southeastern Emergency Physicians LLC, a 786-clinician group and accepts Medicare assignment. Licensed in Tennessee.

Years since qualifying
18
Licensed in
TN
In the registry since
2009
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Practice location Address checks out

5482 Fiesta Dr
Memphis, TN 38120-2827
Phone: (901) 831-1358
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 14186 (TN)

Record details

NPI number1568791259
Entity typeIndividual (Type 1)
GenderFemale
Credentials FNPB-C
Sole proprietorNo
NPI enumeratedDecember 9, 2009
Last updated in NPPESMarch 21, 2024
Certification dateMarch 21, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2008 (18 years in practice)
Group practice Southeastern Emergency Physicians Llc — 786 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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