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NPI Code Detail

MEDICARE: DR. QUANZA ELISE MOORING PHD, FNP-BC

MEDICARE: DR. QUANZA ELISE MOORING PHD, FNP-BC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner4025055KY
2363LF0000XFamily Nurse PractitionerAPRN.CNP.0037108OH
3363LF0000XFamily Nurse Practitioner26NJ15134500NJ
4363LF0000XFamily Nurse Practitioner1110862TX
5363LF0000XFamily Nurse Practitioner36864TN
6363LF0000XFamily Nurse Practitioner356769NY
7363LF0000XFamily Nurse Practitioner0024190959VA
8363LF0000XFamily Nurse PractitionerAPRN04273RI
9363LF0000XFamily Nurse Practitioner5020824NC

General Provider Information

NPI Number : 1770281016
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. QUANZA ELISE MOORING PHD, FNP-BC
Provider Business Mailing Address
First Line : PO BOX 746079
Second Line :
City : ATLANTA
State : GA
Zip : 30374-6079
Country : US
Telephone Number : 281-707-7362
Fax Number :
Provider Business Practice Location Address
First Line : 11260 E JEFFERSON AVE
Second Line :
City : DETROIT
State : MI
Zip : 48214-3320
Country : US
Telephone Number : 313-749-0148
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/16/2023
Last Update Date : 03/13/2026

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