Individual
TINA MARIE MORAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ACNP
Contact information
Practice address
27351 DEQUINDRE RD, MADISON HEIGHTS, MI 48071-3487
(248) 967-7000
Mailing address
27351 DEQUINDRE, MADISON HEIGHTS, MI 48067
(248) 967-7585
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN750803
CA
163WG0000X
General Practice Registered Nurse
4704227573
MI
363L00000X
Nurse Practitioner
NP18939
CA
363LA2100X
Acute Care Nurse Practitioner
Primary
4704227573
MI
363LC0200X
Critical Care Medicine Nurse Practitioner
NP18939
CA
Other
Enumeration date
09/18/2007
Last updated
07/21/2022
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