Individual
ANGELA VICTORIA MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, FNP-C, PMHNP-BC
Contact information
Practice address
850 W BARAGA AVE, MARQUETTE, MI 49855-4550
(906) 449-1600
Mailing address
1301 RYAN AVE APT 4, MARQUETTE, MI 49855-1281
(586) 202-3763
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
4704290287
MI
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
4704290287
MI
Other
Enumeration date
10/14/2021
Last updated
11/18/2024
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