Individual
MS. ELIZABETH J MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
10967 ALLISONVILLE RD STE 240, FISHERS, IN 46038-2634
(216) 468-5000
Mailing address
2514 OAK PARK COURT, RICHMOND, IN 47374-1282
(774) 285-0822
(765) 966-1293
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
28087121A
IN
2084P0800X
Psychiatry Physician
71005185A
IN
2084P0800X
Psychiatry Physician
71005185B
IN
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
71005185A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000899248
ANTHEM
IN
05
—
201258280
—
IN
Enumeration date
09/11/2009
Last updated
04/02/2025
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