Individual
DEBRA A MOON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NNP
Contact information
Practice address
8111 TOWNSHIP LINE RD, INDIANAPOLIS, IN 46260-2479
(317) 415-7921
Mailing address
10330 N MERIDIAN ST # 300, INDIANAPOLIS, IN 46290-1024
Taxonomy
Speciality
Code
Description
License number
State
363LN0000X
Neonatal Nurse Practitioner
Primary
71006265A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201412030
—
IN
Enumeration date
06/28/2016
Last updated
04/19/2017
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