Provider Demographics
NPI:1689080889
Name:MOORE, ARIEL GIBSON (CRNP)
Entity Type:Individual
Prefix:MRS
First Name:ARIEL
Middle Name:GIBSON
Last Name:MOORE
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:3506 KENNETT PIKE STE 230
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19807-3019
Mailing Address - Country:US
Mailing Address - Phone:302-661-3400
Mailing Address - Fax:302-656-5611
Practice Address - Street 1:3506 KENNETT PIKE
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19807-3019
Practice Address - Country:US
Practice Address - Phone:302-661-3400
Practice Address - Fax:302-656-5611
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-08
Last Update Date:2022-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DELP-0000192363LP2300X
MDR187804363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology