Provider Demographics
NPI:1053318949
Name:MOORE SHIVE, GIGI FRANCESCA (CNM)
Entity Type:Individual
Prefix:MS
First Name:GIGI
Middle Name:FRANCESCA
Last Name:MOORE SHIVE
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:GIGI
Other - Middle Name:FRANCESCA
Other - Last Name:MOORE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CNM
Mailing Address - Street 1:6016 ALTAMONT PL
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21210-1002
Mailing Address - Country:US
Mailing Address - Phone:410-340-0170
Mailing Address - Fax:
Practice Address - Street 1:7300 YORK RD
Practice Address - Street 2:
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204-7607
Practice Address - Country:US
Practice Address - Phone:410-427-5470
Practice Address - Fax:410-337-6955
Is Sole Proprietor?:No
Enumeration Date:2005-07-07
Last Update Date:2022-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR131731363LP0808X, 176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
P31768Medicare UPIN
S732H21Medicare ID - Type Unspecified