Individual
JUDY MOORMAN BIRT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1481 W 10TH STREET, AMB 11 RICHARD L ROUDELOUSH VA MEDICAL CENTER, INDIANAPOLIS, IL 46202
(317) 988-2205
(317) 988-4706
Mailing address
1481 W 10TH STREET, AMB 11, INDIANAPOLIS, IL 46202
(317) 988-2205
(317) 988-4706
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
71001146A
IN
Other
Enumeration date
09/14/2006
Last updated
07/08/2007
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