Moore, Elizabeth Jane

Moore, Elizabeth Jane is an individual health care provider with primary practice located at 410 North 10Th Street , Richmond IN 47374-3116. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health, Allopathic & Osteopathic Physicians / Psychiatry. Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health is her primary health care specialty. Moore, Elizabeth Jane can be contacted via phone (774) 285-0822.

Contact Information

Primary practice address
410 North 10Th Street Richmond IN 47374-3116
Phone: (774) 285-0822
Fax: (765) 530-8099
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X 71005185A Indiana
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X 71005185A Indiana
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X 71005185B Indiana
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X 28087121A Indiana

Profile Details

NPI number 1871826610
LBN Legal business name Moore, Elizabeth Jane
Credentials PMHNP-BC
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 11th, 2009
Last updated Apr 4th, 2019 - about 7 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 1871826610 NPPES
Indiana MEDICAID 201258280
Indiana Other 000000899248

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