Moore, Susan John

Moore, Susan John is an individual health care provider with primary practice located at 3118 South Lafountain Indiana Health Center - Kokomo, Kokomo IN 46902-3710. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Gerontology, Physician Assistants & Advanced Practice Nursing Providers / Family. Physician Assistants & Advanced Practice Nursing Providers / Family is her primary health care specialty. Moore, Susan John can be contacted via phone (765) 864-4160.

Contact Information

Primary practice address
3118 South Lafountain Indiana Health Center - Kokomo Kokomo IN 46902-3710
Phone: (765) 864-4160
Fax: (765) 864-4166
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Gerontology 363LG0600X 71003756A Indiana
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 71003756A Indiana

Profile Details

NPI number 1134400864
LBN Legal business name Moore, Susan John
Credentials Family Nurse Practitioner (FNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 8th, 2011
Last updated Jan 24th, 2023 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1134400864 NPPES
Indiana MEDICAID 100071250A

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