MCKENZIE MOORE (NPI# 1346869286) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346869286 |
| Entity Type | Individual |
| Full Name | MCKENZIE MOORE |
| Credential | PHARM.D. |
| Practice Address |
4801 Veterans Dr Saint Cloud MN 56303-2015 |
| Mailing Address |
6340 Ridgewood Rd Unit 222 Saint Cloud MN 56303-1441 |
| Practice Telephone | 3202521670 |
| Mailing Telephone | 4322704445 |
| Enumeration Date | 2020-04-10 |
| Last Update Date | 2020-04-10 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | 64752 | TX | Pharmacy Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760038251 | Mckenzie A Moore | Speech-Language Pathologist | 210 Navajo Trl, Sedona, AZ 86336-3524 | 2019-08-12 |
| 1588276893 | Mckenzie Moore | Behavior Technician | 27777 Inkster Rd Ste 100, Farmington Hills, MI 48334-5326 | 2020-08-18 |
| 1326680703 | Mckenzie Moore | Specialist/Technologist | 615 Vonderburg Dr, Brandon, FL 33511-5972 | 2019-10-17 |
| Street Address |
4801 VETERANS DR |
| City | SAINT CLOUD |
| State | MN |
| Zip Code | 56303-2015 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780675629 | Michelle P Pittman-leyendecker | Nurse Practitioner | 4801 Veterans Dr, Saint Cloud, MN 56303-2015 | 2005-10-31 |
| 1255939773 | Samantha Stager | Registered Nurse | 4801 Veterans Dr, Saint Cloud, MN 56303-2015 | 2020-10-16 |
| 1447866587 | Alyssa L Pumford | Dietitian, Registered | 4801 Veterans Dr, Saint Cloud, MN 56303-2015 | 2020-09-22 |
| 1427663905 | John David Estep | Social Worker | 4801 Veterans Dr, B28 Rm 155, Saint Cloud, MN 56303-2099 | 2020-09-11 |
| 1962012823 | Kelly A Pittman | Social Worker | 4801 Veterans Dr, Saint Cloud, MN 56303-2015 | 2020-08-05 |
| 1356951297 | Alyssa Anne Berscheid | Registered Nurse | 4801 Veterans Dr, Saint Cloud, MN 56303-2015 | 2020-08-05 |
| 1790395861 | Anna Elisabeth Lee | Dietitian, Registered | 4801 Veterans Dr, Saint Cloud, MN 56303-2015 | 2020-08-04 |
| 1932718004 | Bradee Schiefelbein | Audiologist | 4801 Veterans Dr, Saint Cloud, MN 56303-2015 | 2020-07-24 |
| 1346865532 | Kali Rae Pichotta | Nurse Practitioner | 4801 Veterans Dr, Saint Cloud, MN 56303-2015 | 2020-06-12 |
| 1174145783 | Renae Elizabeth Lockerby | Social Worker | 4801 Veterans Dr, Saint Cloud, MN 56303-2015 | 2020-05-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841800463 | Daniel P Lahr | Radiologic Technologist | St Cloud Va Health Care System, 4801 Veterans Drive, St Cloud, MN 56303 | 2020-08-07 |
| 1730798398 | County of Stearns | Case Management | 705 Courthouse Square, St Cloud, MN 56303 | 2020-07-29 |
| 1669007126 | Aflah Transportation LLC | Non-emergency Medical Transport (VAN) | 3316 3rd Street North, Suite 129, Saint Cloud, MN 56303 | 2020-03-05 |
| 1609420942 | Stephanie Lynne Metzger | Nurse Practitioner | Centracare Clinic Riverc Ampus/nephrology, 1200 Sixth Ave North, St. Cloud, MN 56303 | 2019-07-25 |
| 1306406947 | Willow Tree Acupuncture LLC | Acupuncturist | 203 Cooper Ave N Suite 160, St. Cloud, MN 56303 | 2019-06-17 |
| 1821553520 | Alan Melvin Hoeper | Nurse Anesthetist, Certified Registered | Centracare Clinic Anesthesiology, 3701 12th St N, Suite 202, St. Cloud, MN 56303 | 2019-02-06 |
| 1437644465 | Brianna Larissa Justin | Speech-Language Pathologist | St. Cloud Hospital, 1406 6th Avenue N, St. Cloud, MN 56303 | 2018-06-22 |
| 1780186486 | Simplicity Health Pa | Family Medicine | 1511 Northway Dr Ste 103, Saint Cloud, MN 56303 | 2018-03-08 |
| 1639682925 | Dereje Beyene | Respiratory Therapist, Certified | 1406 15th Street North, Saint Cloud, MN 56303 | 2017-11-09 |
| 1740792761 | Lisa Ann Horner | Nurse Practitioner | 1555 Northway Drive #110, Centracare Complex Care Clinic, St Cloud, MN 56303 | 2017-10-31 |
| Find all providers in zip 56303 | ||||
| Taxonomy Code | 183500000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
| Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962021154 | Svetlana Stukalova | Pharmacist | 4201 W Division St Ste A124, Saint Cloud, MN 56301-6601 | 2020-04-08 |
| 1942724471 | Sarah Elizabeth Hart | Pharmacist | 1710 E Clinton Dr, Saint Cloud, FL 34769-5506 | 2017-07-26 |
| 1326561002 | Shastri Ryan Ramsook | Pharmacist | 3891 Marietta Way, Saint Cloud, FL 34772-8716 | 2017-07-25 |
| 1689059438 | Alexandra Jae Jenson | Pharmacist | 2118 8th St N, Saint Cloud, MN 56303-6150 | 2015-07-22 |
| 1154714145 | Tania Torres | Pharmacist | 3770 Marietta Way, Saint Cloud, FL 34772-8710 | 2015-03-15 |
| 1093135337 | Carmelita Garzon Sevilla | Pharmacist | 319 Vermont Ave, Saint Cloud, FL 34769-2249 | 2014-04-25 |
| 1881011153 | Jeffrey Wick | Pharmacist | 501 Highway 10 S, Saint Cloud, MN 56304-1250 | 2014-03-25 |
| 1003181033 | Siby Thomas Puthenpurayil | Pharmacist | 4073 13th St, Saint Cloud, FL 34769-6701 | 2012-03-08 |
| 1801169560 | Annie Preisler | Pharmacist | 5923 Prairie Rose Dr, Saint Cloud, MN 56303-1144 | 2012-02-10 |
| 1699069062 | Lynn R Young | Pharmacist | 1921 Coborn Blvd, Saint Cloud, MN 56301-2100 | 2011-06-02 |
| Find all providers in SAINT CLOUD | ||||
| City | SAINT CLOUD |
| Zip Code | 56303 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.