Individual
AMY JO MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1332 WATERFORD CIR, GOSHEN, IN 46526-6009
(574) 534-3920
Mailing address
1222 E BEARDSLEY AVE, ELKHART, IN 46514-3504
(574) 343-4038
Taxonomy
Speciality
Code
Description
License number
State
163WG0600X
Gerontology Registered Nurse
Primary
28229536A
IN
Other
Enumeration date
07/15/2021
Last updated
07/15/2021
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