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General NPI Number Information
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NPI Number | 1659494128
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Entity Type | Individual
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Provider Name | SUSAN MOSLEY ARNP
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Gender | Female
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Dates
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Enumeration Date | 04/09/2007
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Last Update Date | 09/13/2011
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Provider Practice Location Address
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Address Line | 4401 E 10TH ST STE 24
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City | INDIANAPOLIS
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State | IN
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Zip | 46201-2754
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Country | US
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Telephone | 317-358-8060
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Fax | 317-358-8058
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Provider Business Mailing Address
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Address Line | 8910 PURDUE RD STE 500
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City | INDIANAPOLIS
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State | IN
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Zip | 46268-3161
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | ARNP1292632
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 71002534A
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License Number State | IN
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