Christine Jenifer Mora, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

IN71000551 Issued in IN

Practice address

6404 Woodthrush Dr
Fort Wayne, IN 46835-1325

Phone

(260) 414-6572

NPI assigned

Aug 27, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1188172800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707782400000",
    "number": "1396938981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6404 WOODTHRUSH DR",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468351325",
            "telephone_number": "260-414-6572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6404 WOODTHRUSH DR",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468351325",
            "telephone_number": "260-414-6572"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORA",
        "first_name": "CHRISTINE",
        "middle_name": "JENIFER",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-08-27",
        "last_updated": "2024-02-13",
        "certification_date": "2024-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "IN71000551",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sheronda Chantell Moore, MSOT, OTR/L
• Starr R Moore
• Toya Moore
• Vincent Paul Moore, MD, MPH
• Virginia M Moore, LMHC, LSW, MS ED,
• Yaimir Mora
• Angela M Morales
• Michelle Lee Morales, LMHCA
• David John Moran, MD
• Steven Moran, C.R.N.A.

• Nurse Practitioner in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2024; 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.