Amanda Moore, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

27079375A Issued in IN

Practice address

3640 N Briarwood LN
Muncie, IN 47304-6375

Phone

(463) 777-5770

NPI assigned

Jul 18, 2023

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1689638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689638400000",
    "number": "1255010039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3522 HIGHFIELD CT APT C",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462221667",
            "telephone_number": "757-768-0837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3640 N BRIARWOOD LN",
            "city": "MUNCIE",
            "state": "IN",
            "postal_code": "473046375",
            "telephone_number": "463-777-5770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "AMANDA",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-07-18",
        "last_updated": "2023-07-18",
        "certification_date": "2023-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "IN",
            "license": "27079375C",
            "primary": false
        },
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "IN",
            "license": "27079375A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julie Mongeri-McPherson
• Monroe TWP. / Cowan Volunteer Fire Department, Inc.
• Matthew Wayne Monroe, RN
• Jason Montgomery, PA-C
• Amber Moody, LMHC
• Fonda Moore
• Jalea Moore
• Jaliyah Moore
• John W. Moore, D.C.
• Kelsey Jo Moore, NP

• Licensed Practical Nurse in Muncie, IN
• Providers in Muncie, IN by specialty
• Licensed Practical Nurse in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.