| Joanna Leigh Moore, FNP-BC | |
|
661 E Main St, Peru, IN 46970-2662 | |
| (765) 472-2519 | |
| (765) 400-4465 |
| Full Name | Joanna Leigh Moore |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner - Family |
| Location | 661 E Main St, Peru, Indiana |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326686395 | NPI | - | NPPES |
| 300036259 | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363LF0000X | Nurse Practitioner - Family | 28164395A (Indiana) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | 71009786A (Indiana) | Primary |
| Entity Name | Indiana Health Centers Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1598776742 PECOS PAC ID: 3971599473 Enrollment ID: O20040430001159 |
| Mailing Address | Practice Location Address |
|---|---|
| Joanna Leigh Moore, FNP-BC 8003 Castleway Dr, Indianapolis, IN 46250-1946 Ph: (175) 761-3353 | Joanna Leigh Moore, FNP-BC 661 E Main St, Peru, IN 46970-2662 Ph: (765) 472-2519 |
Phyllis Annette Ingham, NP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 750 N Broadway, Peru, IN 46970 Phone: 260-569-2120 Fax: 260-569-2121 | |
Heather Weber, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 315 W Old Key Dr, Peru, IN 46970 Phone: 765-475-6963 Fax: 765-475-2833 | |
Elaine Olson, Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 315 W Old Key Dr Ste 150, Peru, IN 46970 Phone: 765-430-7507 Fax: 765-475-2839 | |
Jay Lee Hoeksema, NP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 661 E Main St, Peru, IN 46970 Phone: 765-472-2519 Fax: 765-400-4465 | |
Katina A Everding, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 2484 S Business 31, Suite C, Peru, IN 46970 Phone: 765-472-2722 Fax: 765-472-2722 | |
Monica Lynn Mcmain, NP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1694 W Logansport Rd, Peru, IN 46970 Phone: 765-472-2519 |