MEDICARE: MERCY MOTO APN

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	07004940A	IN
2	363LF0000X	Family Nurse Practitioner	71004940A	IN

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	P01679081	OTHER	IN	MEDICARE RR

Other Identifiers

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

General Provider Information

NPI Number	:	1477859742
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MERCY MOTO APN

Provider Business Mailing Address
First Line	:	7962 OAKLANDON RD STE 104
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46236-7502
Country	:	US
Telephone Number	:	317-676-9952
Fax Number	:	317-647-4375

Provider Business Practice Location Address
First Line	:	7962 OAKLANDON RD STE 104
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46236-7502
Country	:	US
Telephone Number	:	317-676-9952
Fax Number	:	317-647-4375

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

Provider Enumeration Date	:	02/04/2011
Last Update Date	:	02/21/2026

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Directions to “ MERCY MOTO APN” Practice Location

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