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Individual

SARAH MICHELLE MOORE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN-CNM, PMHNP-BC

Contact information

Practice address
909 E STATE BLVD, FORT WAYNE, IN 46805-3404
(260) 481-2700
(260) 481-2838
Mailing address
11109 PARKVIEW PLAZA DR # 117, FORT WAYNE, IN 46845-1701

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN.446639
OH
363L00000X
Nurse Practitioner
Primary
71009864A
IN
367A00000X
Advanced Practice Midwife
APRN.CNM.019414
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
09000336A
NURSE MIDWIFE
IN
01
2022138568
PMHNP-BC
01
28255494A
REGISTERED NURSE
IN
01
71009864A
APRN
IN
01
APRN.CNM.019414
APRN
OH
01
CNM05835
CERTIFIED NURSE MIDWIFE
01
RN.446639
REGISTERED NURSE
OH
Enumeration date
10/28/2019
Last updated
08/29/2023
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