Individual
GLORIA L MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
18000 W 9 MILE RD STE 525, SOUTHFIELD, MI 48075-4080
(248) 327-6196
(877) 311-5596
Mailing address
5316 LAKESHORE RD, FORT GRATIOT, MI 48059-3118
(810) 357-8792
(810) 512-7725
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
—
—
1041C0700X
Clinical Social Worker
—
—
163WW0000X
Wound Care Registered Nurse
4704263386
MI
163WX1500X
Ostomy Care Registered Nurse
4704263386
MI
225200000X
Physical Therapy Assistant
—
—
363LF0000X
Family Nurse Practitioner
Primary
4704301246NSA220SA
MI
363LP2300X
Primary Care Nurse Practitioner
4704263386
MI
Other
Enumeration date
09/19/2022
Last updated
04/06/2026
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