=====================================================
General NPI Number Information
=====================================================
NPI Number | 1477859742
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MERCY MOTO APN
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/04/2011
-----------------------------------------------------
Last Update Date | 12/15/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 7962 OAKLANDON RD STE 104
-----------------------------------------------------
City | INDIANAPOLIS
-----------------------------------------------------
State | IN
-----------------------------------------------------
Zip | 46236-7502
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 317-676-9952
-----------------------------------------------------
Fax | 317-647-4375
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 7962 OAKLANDON RD STE 104
-----------------------------------------------------
City | INDIANAPOLIS
-----------------------------------------------------
State | IN
-----------------------------------------------------
Zip | 46236-7502
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 317-676-9952
-----------------------------------------------------
Fax | 317-647-4375
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LP0808X
-----------------------------------------------------
Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
-----------------------------------------------------
License Number | 07004940A
-----------------------------------------------------
License Number State | IN
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | 71004940A
-----------------------------------------------------
License Number State | IN
-----------------------------------------------------