Individual
ALYSSA MARIE MOON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
138 N DIXON RD, KOKOMO, IN 46901-4154
(765) 236-8282
Mailing address
138 N DIXON RD, KOKOMO, IN 46901-4154
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
18004578283
IN
363LF0000X
Family Nurse Practitioner
Primary
71014484A
IN
Other
Enumeration date
09/27/2023
Last updated
11/11/2024
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