Individual
GINA L MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
530 N MICHIGAN ST, ARGOS, IN 46501-1134
(574) 892-5131
(574) 223-5847
Mailing address
1400 E 9TH ST, ROCHESTER, IN 46975-8931
(574) 224-1044
(574) 224-1103
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
71001226A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200862210
—
IN
Enumeration date
11/11/2005
Last updated
10/02/2014
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