MEDICARE: JUSTINE MOESNER FNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	71013290A	IN
2	363L00000X	Nurse Practitioner	71013290A	IN

General Provider Information

NPI Number	:	1518676816
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JUSTINE MOESNER FNP

Provider Business Mailing Address
First Line	:	4011 GATEWAY BLVD
Second Line	:
City	:	NEWBURGH
State	:	IN
Zip	:	47630-8947
Country	:	US
Telephone Number	:	812-842-3880
Fax Number	:	812-842-3916

Provider Business Practice Location Address
First Line	:	4011 GATEWAY BLVD
Second Line	:
City	:	NEWBURGH
State	:	IN
Zip	:	47630-8947
Country	:	US
Telephone Number	:	812-842-3880
Fax Number	:	812-842-3916

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/16/2022
Last Update Date	:	01/14/2026

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Directions to “ JUSTINE MOESNER FNP” Practice Location

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