Moore, Gale

Moore, Gale is an individual health care provider with primary practice located at 1401 Oak St , Grenada MS 38901-4633. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Obstetrics & Gynecology, Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife. Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife is her primary health care specialty. Moore, Gale can be contacted via phone (662) 226-4010.

Contact Information

Primary practice address
1401 Oak St Grenada MS 38901-4633
Phone: (662) 226-4010
Fax: (662) 226-4495
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Obstetrics & Gynecology 363LX0001X R525294 Mississippi
Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife 367A00000X R525294 Mississippi

Profile Details

NPI number 1962582585
LBN Legal business name Moore, Gale
Credentials Certified Nurse Midwife (CNM)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 17th, 2006
Last updated Jan 4th, 2012 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1962582585 NPPES
Mississippi MEDICAID 00111153

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