Individual
ELIZABETH MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
100 ST MARYS EPWORTH XING STE B100, NEWBURGH, IN 47630-9161
(812) 853-9651
Mailing address
250 N SHADELAND AVE STE 200, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10002774A
IN
363A00000X
Physician Assistant
—
—
Other
Enumeration date
08/19/2019
Last updated
09/16/2020
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