Individual
PATRICIA S MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
STAFF NURSE
Contact information
Practice address
1481 W 10TH ST, INDIANAPOLIS, IN 46202-2803
(317) 554-0181
(317) 554-0105
Mailing address
968 JUNCO DR, COLUMBUS, IN 47203-1369
(812) 372-6156
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
28060812A
IN
Other
Enumeration date
06/27/2006
Last updated
07/08/2007
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