Healthcare Provider Details

I. General information

NPI: 1245997857
Provider Name (Legal Business Name): NANETTE LANA RICHARDS FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: NANETTE LANA MOORE

II. Dates (important events)

Enumeration Date: 11/18/2021
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8455 KEYSTONE XING STE 300
INDIANAPOLIS IN
46240-4353
US

IV. Provider business mailing address

2485 DIRECTORS ROW STE D
INDIANAPOLIS IN
46241-4907
US

V. Phone/Fax

Practice location:
  • Phone: 845-205-6004
  • Fax: 317-969-6727
Mailing address:
  • Phone: 317-941-7338
  • Fax: 317-969-6727

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberF04210355
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number71012013A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: