Provider Demographics
NPI:1679361331
Name:MOON, CINDI A
Entity type:Individual
Prefix:
First Name:CINDI
Middle Name:A
Last Name:MOON
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:CYNTHIA
Other - Middle Name:ANN
Other - Last Name:MOON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN
Mailing Address - Street 1:937 N IRVINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46219-4333
Mailing Address - Country:US
Mailing Address - Phone:317-727-5037
Mailing Address - Fax:
Practice Address - Street 1:8530 TOWNSHIP LINE RD
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46260-1927
Practice Address - Country:US
Practice Address - Phone:317-472-5059
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-30
Last Update Date:2025-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28314100163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health