Individual
AUDRA LYN MOOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
950 N MERIDIAN ST, INDIANAPOLIS, IN 46204-1077
(317) 963-6100
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
28212891A
IN
363LF0000X
Family Nurse Practitioner
Primary
71009047A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300131781
—
IN
Enumeration date
06/13/2019
Last updated
07/13/2026
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