Provider Demographics
NPI:1477636025
Name:MOSSMAN, CYNTHIA L (NP)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:L
Last Name:MOSSMAN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 1026
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46206-1026
Mailing Address - Country:US
Mailing Address - Phone:317-274-1201
Mailing Address - Fax:317-278-9905
Practice Address - Street 1:8111 S EMERSON AVE
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46237-8601
Practice Address - Country:US
Practice Address - Phone:317-865-5146
Practice Address - Fax:317-865-5148
Is Sole Proprietor?:No
Enumeration Date:2006-10-24
Last Update Date:2010-09-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IN71001889363LN0000X
IN28078431363LN0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal