Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Bridget Moore

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1104405414

Bridget Moore is a Student in an Organized Health Care Education/Training Program in Grand Rapids, Michigan. Licensed in Michigan. Registered with an NPI since 2021.

Licensed in
MI
In the registry since
2021
Specialties on file
2
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Practice location Address checks out

330 Barclay Ave NE Ste 300
Grand Rapids, MI 49503-2527
Phone: (616) 391-8810
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pediatrics Physician (primary) Taxonomy 208000000X · Licence 4351047958 (MI)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1104405414
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedApril 5, 2021
Last updated in NPPESMay 25, 2022
Certification dateMay 25, 2022

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