Provider Demographics
NPI:1174396998
Name:BYERS, MORAA M (NP)
Entity type:Individual
Prefix:
First Name:MORAA
Middle Name:M
Last Name:BYERS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:MORAA
Other - Middle Name:MARTHA
Other - Last Name:OGEGA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8901 RIVER CROSSING BLVD APT 452
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46240-3696
Mailing Address - Country:US
Mailing Address - Phone:317-657-8408
Mailing Address - Fax:
Practice Address - Street 1:8901 RIVER CROSSING BLVD APT 452
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46240-3696
Practice Address - Country:US
Practice Address - Phone:317-657-8408
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-02
Last Update Date:2023-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71014303A363LA2200X, 363LP2300X, 363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care