Organization
LIFESPAN ADVANCED CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHEN MOORE, MD (OWNER)
(812) 332-2265
Entity
Organization
Contact information
Practice address
118 MEDICAL DR, CARMEL, IN 46032-3323
(317) 781-4500
(317) 781-4500
Mailing address
PO BOX 181168, FAIRFIELD, OH 45018-1168
(317) 781-4500
(317) 781-4500
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
—
—
363LG0600X
Gerontology Nurse Practitioner
Primary
—
—
Other
Enumeration date
10/17/2025
Last updated
03/20/2026
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