ROSALIE MOORE


Address: 2240 E 53rd St # B-1, Indianapolis, IN 46220-3479
Phone: 3176532730

ROSALIE MOORE (NPI# 1104355379) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1104355379
Entity Type Individual
Full Name ROSALIE MOORE
Other Name ROSALIE BAKER
Credential NP
Practice Address 2240 E 53rd St # B-1
Indianapolis
IN 46220-3479
Mailing Address 30 W Monroe St Ste 1200
Chicago
IL 60603-2420
Practice Telephone 3176532730
Practice Fax Number 3173211935
Mailing Telephone 3127339730
Mailing Fax Number 7738668014
Enumeration Date 2017-06-09
Last Update Date 2020-06-23
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363LG0600X Nurse Practitioner
Specialization: Gerontology
28027184A IN Physician Assistants & Advanced Practice Nursing Providers

Other Provider Identifier

State Issuer Identifier Type Code
IN RN LICENSE NUMBER 28027184A 01

Office Location

Street Address 2240 E 53RD ST # B-1
City INDIANAPOLIS
State IN
Zip Code 46220-3479

Providers in the same location

NPI Name Taxonomy Address Enumeration
1164815353 Dawn Nicole Paddock Nurse Practitioner 2240 E 53rd St # B-1, Indianapolis, IN 46220-3479 2015-03-11
1245766922 Elizabeth Beers Nurse Practitioner 2240 E 53rd St # B-1, Indianapolis, IN 46220-3479 2017-05-02

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Taxonomy Information

Taxonomy Code 363LG0600X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Gerontology

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1417567249 Sarah E Munson Nurse Practitioner 1633 N Capitol Ave Ste 680, Indianapolis, IN 46202-1281 2020-08-06
1750844890 Sarah Kathleen Cherry Nurse Practitioner 4326 Maldenhair Dr, Indianapolis, IN 46239-9033 2019-04-06
1184103459 Katherine Rose Ahaus Nurse Practitioner 1801 Senate Blvd Ste 230, Indianapolis, IN 46202-1252 2018-08-08
1386197770 Masita Isabel Poray Nurse Practitioner 5435 E 16th St Ste 500, Indianapolis, IN 46218-4869 2016-08-02
1316370612 Paradigm Living Concepts, LLC Nurse Practitioner 8904 Bash St Ste B, Indianapolis, IN 46256-1286 2013-08-10
1902414709 Michelle Nicole Gibson Nurse Practitioner 1801 N Senate Blvd, Indianapolis, IN 46202-1228 2020-07-17
1467081455 Sarah Elizabeth Wheeler Nurse Practitioner 1801 N Senate Blvd Ste 635, Indianapolis, IN 46202-1212 2020-04-02
1154965531 Monica Deryckere Nurse Practitioner 8424 Naab Rd Ste 1l, Indianapolis, IN 46260-1954 2019-10-29
1699318592 Marcy Penrod Nurse Practitioner 8333 Naab Rd, Indianapolis, IN 46260-5924 2019-10-23
1124677000 Amanda Marie Mccoy Ignaut Nurse Practitioner 1402 E County Line Rd, Indianapolis, IN 46227-0963 2019-09-04
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Competitor

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City INDIANAPOLIS
Zip Code 46220

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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