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MRS. KATIE RAE MOORE LPN
NPI 1619671583
Licensed Practical Nurse in Fort Wayne, IN

Active since March 27, 2023
2121 LAKE AVE, FORT WAYNE, IN 46805(260) 425-5431(260) 421-1092 Get Directions Write a Review

NPPES record last updated: March 27, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Mrs. Katie Rae Moore Lpn NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MRS. KATIE RAE MOORE LPN (NPI 1619671583) is an individual licensed practical nurse in Fort Wayne, Indiana, licensed in Indiana (27078323A) and active in the NPI registry since March 2023.

NPPES Registry Identity

NPI1619671583
Entity TypeIndividualFemale
Primary Taxonomy164W00000X
Provider Legal NameMRS. KATIE RAE MOORECredential: LPN
Location Address2121 LAKE AVEFort Wayne, IN 46805-5100
Mailing Address1924 N Tyland BlvdNew Haven, IN 46774-1546 · (260) 705-5788
Phone(260) 425-5431
Fax(260) 421-1092
Sole ProprietorNo
Enumeration DateMarch 27, 2023
NPPES CertifiedMarch 27, 2023
✔ NPI 1619671583 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyLicensed Practical NurseNursing Service Providers
Taxonomy Code164W00000X
License✔ Licensed in IN · 27078323A
Definition
A licensed practical nurse with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states.
2121 LAKE AVE, Fort Wayne, IN 46805
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Other Names 1

Former Name (1)Katie Rae Clemens

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

TAMMY MOEHLE
Registered Nurse (Oncology)
2121 LAKE AVE
FORT WAYNE, IN 46805
Allen County (260) 426-5431
DR. CALEB ANDREW MOSSBURG PHARMD
Pharmacist
2121 LAKE AVE
FORT WAYNE, IN 46805
Allen County (260) 426-5431
DR. ASHLEY M FULTON PHARMD
Pharmacist (Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist)
2121 LAKE AVE
FORT WAYNE, IN 46805
Allen County (260) 426-5431
HANNAH DULINSKY RN
Registered Nurse (Home Health)
2121 LAKE AVE
FORT WAYNE, IN 46805
Allen County (260) 460-1445
DANIELLE SCHULTZ
Registered Nurse
2121 LAKE AVE
FORT WAYNE, IN 46805
Allen County (260) 426-5431
DR. IAN H. COOK M.D.
Surgery
2121 LAKE AVE, VETERANS AFFAIRS MEDICAL CENTER
FORT WAYNE, IN 46805
Allen County (260) 426-5431
SCOTT KRUSE
Social Worker (Clinical)
2121 LAKE AVE
FORT WAYNE, IN 46805
Allen County (260) 426-5431
MONICA JANE HALL
Registered Nurse (General Practice)
2121 LAKE AVE
FORT WAYNE, IN 46805
Allen County (260) 456-0543

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Katie Moore's NPI number?

The NPI number for Katie Moore is 1619671583. It was assigned to this individual provider in the NPPES registry on March 27, 2023. The provider is also known as Katie Rae Clemens.

Where is Katie Moore located?

Katie Moore practices at 2121 Lake Ave, Fort Wayne, IN 46805. The listed phone number is (260) 425-5431.

What is Katie Moore's specialty?

The primary specialty registered for this NPI is Licensed Practical Nurse with taxonomy code 164W00000X.

When was this NPI record last updated?

The NPPES record for Katie Moore was last updated on March 27, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.