Individual
AMANDA MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
3640 N BRIARWOOD LN, MUNCIE, IN 47304-6375
(463) 777-5770
Mailing address
3522 HIGHFIELD CT APT C, INDIANAPOLIS, IN 46222-1667
(757) 768-0837
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
27079375A
IN
164W00000X
Licensed Practical Nurse
27079375C
IN
Other
Enumeration date
07/18/2023
Last updated
07/18/2023
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