Individual
MRS. ANGELIQUE DENISE MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP-C, RN
Contact information
Practice address
29205 GLENCASTLE CT, FARMINGTON HILLS, MI 48336-1416
(248) 470-2120
(248) 470-2120
Mailing address
29205 GLENCASTLE CT, FARMINGTON HILLS, MI 48336-1416
(248) 943-4535
(248) 552-8144
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
4704195802
MI
363LF0000X
Family Nurse Practitioner
Primary
4704195802NSA17232
MI
Other
Enumeration date
03/10/2010
Last updated
07/21/2022
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