Healthcare Provider Details

I. General information

NPI: 1053951962
Provider Name (Legal Business Name): GABRIELLA ROBIN MOORE DNP, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: GABRIELLA R WORDEN

II. Dates (important events)

Enumeration Date: 01/08/2020
Last Update Date: 12/01/2025
Certification Date: 12/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 SALMON CREEK LN
JUNEAU AK
99801
US

IV. Provider business mailing address

1200 SALMON CREEK LN
JUNEAU AK
99801-7861
US

V. Phone/Fax

Practice location:
  • Phone: 907-463-4040
  • Fax:
Mailing address:
  • Phone: 907-463-4040
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number181103
License Number StateAK
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN60868202
License Number StateWA
# 3
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number176808
License Number StateAK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: