Individual
JANICE MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
200 HIGH PARK AVE, GOSHEN, IN 46526-4810
(317) 340-8384
Mailing address
450 E 96TH ST STE 200, INDIANAPOLIS, IN 46240-3797
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
209012796
IL
367500000X
Certified Registered Nurse Anesthetist
28147329A
IN
Other
Enumeration date
11/09/2012
Last updated
07/09/2024
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