MEDICARE: ANDREA L MOSER NP

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	71004090A	IN

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	068010017	OTHER	IN	MEDICARE PTAN
2	264431022	OTHER	IN	MEDICARE PTAN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1770831810
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDREA L MOSER NP

Provider Business Mailing Address
First Line	:	705 SUGARBUSH DR
Second Line	:
City	:	ZIONSVILLE
State	:	IN
Zip	:	46077-1910
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	980 INDIANA AVE
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46202-2915
Country	:	US
Telephone Number	:	317-274-8214
Fax Number	:	317-274-7657

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

Provider Enumeration Date	:	08/21/2012
Last Update Date	:	07/26/2024

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Directions to “ ANDREA L MOSER NP” Practice Location

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