Individual
MS. GWENDOLYN CALLA MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP
Contact information
Practice address
148 EAST AVE STE 3G, NORWALK, CT 06851-5727
(203) 838-4034
(203) 853-6361
Mailing address
148 EAST AVE STE 3G, NORWALK, CT 06851-5727
(203) 838-4034
(203) 853-6351
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
10129
CT
363LP0200X
Pediatric Nurse Practitioner
382340
NY
Other
Enumeration date
02/22/2013
Last updated
06/07/2024
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