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Individual

ANDREA L MOSER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
980 INDIANA AVE, INDIANAPOLIS, IN 46202-2915
(317) 274-8214
(317) 274-7657
Mailing address
705 SUGARBUSH DR, ZIONSVILLE, IN 46077-1910

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
71004090A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
068010017
MEDICARE PTAN
IN
05
201096770
IN
01
264431022
MEDICARE PTAN
IN
Enumeration date
08/21/2012
Last updated
07/26/2024
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