Individual
MICHELLE STOYANOV MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
303 N 7TH ST, KENTLAND, IN 47951-1379
(219) 474-5464
Mailing address
303 N 7TH ST, KENTLAND, IN 47951-1379
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10004666A
IN
Other
Enumeration date
07/10/2024
Last updated
12/01/2025
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