Individual
KELSEY JO MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
3631 N MORRISON RD, MUNCIE, IN 47304-5547
(765) 213-6304
(765) 213-6304
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
28189740A
IN
363LA2200X
Adult Health Nurse Practitioner
Primary
71005216A
IN
Other
Enumeration date
10/21/2014
Last updated
03/18/2022
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