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Individual

ROSALIE MOORE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
2240 E 53RD ST # B-1, INDIANAPOLIS, IN 46220-3479
(317) 653-2730
(317) 321-1935
Mailing address
30 W MONROE ST STE 1200, CHICAGO, IL 60603-2420
(312) 733-9730
(773) 866-8014

Taxonomy

Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
28027184A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
28027184A
RN LICENSE NUMBER
IN
Enumeration date
06/09/2017
Last updated
06/23/2020
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