Individual
LORI GROSS MOONEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP-PMH
Contact information
Practice address
532 EASTERN BLVD, SUITE 202, ESSEX, MD 21221-6738
(410) 391-8240
(443) 460-0293
Mailing address
532 EASTERN BLVD, SUITE 202, ESSEX, MD 21221-6738
(410) 391-8240
(443) 460-0293
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
R169704
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
332518100
—
MD
Enumeration date
06/30/2010
Last updated
04/07/2016
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