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Individual

LILY MOORE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
515 E MARKET ST APT 502, INDIANAPOLIS, IN 46204-3051
(317) 696-8404
Mailing address
PO BOX 2213, CLARKSVILLE, IN 47131-2213
(812) 284-2273

Taxonomy

Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
2019051245
IN
363LF0000X
Family Nurse Practitioner
Primary
71009935A
IN

Other

Enumeration date
11/22/2019
Last updated
07/30/2021
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