SANDRA J. MOORE (NPI# 1851510366) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1851510366 |
| Entity Type | Individual |
| Full Name | SANDRA J. MOORE |
| Credential | NP |
| Practice Address |
1425 Main St N Pine City MN 55063-6026 |
| Practice Telephone | 3206297505 |
| Practice Fax Number | 3206292202 |
| Mailing Telephone | 3206297505 |
| Mailing Fax Number | 3206292202 |
| Enumeration Date | 2007-04-24 |
| Last Update Date | 2014-06-02 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363L00000X | Nurse Practitioner | 157868 | WI | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
R 181983-4 | MN | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629532569 | Sandra Ann Moore | Substance Abuse Rehabilitation Facility | 2632 E 17th St, Bremerton, WA 98310-5058 | 2019-01-24 |
| 1942701826 | Sandra Moore | Licensed Practical Nurse | 48 Huntley Rd, Elmont, NY 11003-1407 | 2018-02-26 |
| 1083038350 | Sandra Moore | Occupational Therapist | Psc 76 Box 263, 65th Med Group/sgh, Apo, AE 09720-0003 | 2014-02-07 |
| 1376843714 | Sandra Jeanne Moore | Registered Nurse | 107 W Broadway, Pathway's Behavioral Health Care, Eldorado Springs, MO 64744 | 2010-11-02 |
| 1073767232 | Sandra Smith Moore | Physical Therapist | 3915 Puckett Creek Xing, E823, Murfreesboro, TN 37128-4260 | 2008-11-13 |
| 1790906741 | Sandra C Moore | Pharmacist | 160 N Post Rd, West Windsor, NJ 08550-5003 | 2007-05-01 |
| 1023135886 | Sandra Moore | Licensed Practical Nurse | 130 Preserve Dr, Royal Palm Beach, FL 33411-1569 | 2007-03-24 |
| 1881725802 | Sandra Evette Moore | Social Worker | 2506 Lesh Ct, Crofton, MD 21114-3221 | 2007-03-08 |
| 1396804167 | Sandra Moore | Nurse Practitioner | Of State 2401 E St Nw, M Med Qi, Sa 1, Washington, DC 20522-0001 | 2006-12-08 |
| 1285725523 | Sandra J Moore | Chiropractor | 1971 Holton Rd, Suite B, North Muskegon, MI 49445-1698 | 2006-09-28 |
| Street Address |
1425 MAIN ST N |
| City | PINE CITY |
| State | MN |
| Zip Code | 55063-6026 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649365628 | Aileen M Roberts | Occupational Therapist | 1425 Main St N, Pine City, MN 55063-6026 | 2006-10-04 |
| 1255945903 | Melinda Margaret Mckay | Nurse Practitioner | 1425 Main St N, Pine City, MN 55063-6026 | 2020-09-01 |
| 1871031856 | Kalli Gilbertson | Physical Therapist | 1425 Main St N, Pine City, MN 55063-6026 | 2017-02-09 |
| 1295108421 | Sheryl Elaine Anderson | Physician Assistant | 1425 Main St N, Pine City, MN 55063-6026 | 2015-11-10 |
| 1588031090 | Sarah Marie Carpenter | Occupational Therapist | 1425 Main St N, Pine City, MN 55063-6026 | 2015-09-01 |
| 1144615204 | Rebecca Catherine Zelenko | Specialist/Technologist | 1425 Main St N, Pine City, MN 55063-6026 | 2015-04-05 |
| 1407276264 | County of Kanabec | Pharmacy | 1425 Main St N, Pine City, MN 55063-6026 | 2014-04-21 |
| 1154769339 | Kristen Christopherson | Specialist/Technologist | 1425 Main St N, Pine City, MN 55063-6026 | 2013-06-10 |
| 1992956999 | Joseph Dvorak | Pharmacist | 1425 Main St N, Pine City, MN 55063-6026 | 2008-10-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861025595 | B&b Guardian Angels Home Care Services, Inc | Home Health | 27680 Beroun Crossing Road, Pine City, MN 55063 | 2020-02-21 |
| 1346684289 | Power Chairs and Scooter Store Medical Supply LLC | Durable Medical Equipment & Medical Supplies | 540 Main St S, Pine City, MN 55063 | 2013-04-22 |
| 1225387327 | Avalon Meridian Behavioral Health | Health Maintenance Organization | 645 3rd Avenue Sw, Pine City, MN 55063 | 2012-09-05 |
| 1629226949 | Community Supports Programming Services LLC | Home Health | 500 3rd Ave Se, Suite 2, Pine City, MN 55063 | 2008-08-28 |
| 1033233788 | Meadow Creek LLC | Substance Abuse Rehabilitation Facility | 17305 Meadow Creek Lane, Pine City, MN 55063 | 2007-03-19 |
| 1477647006 | Rachel E Waxberg | Chiropractor | 805 Main Street South, Pine City, MN 55063 | 2006-10-03 |
| 1306947494 | Joseph Norbert Nilsson | Chiropractor | 253 5th St Se, Pine City, MN 55063 | 2006-09-25 |
| 1851324313 | Pine Eye Associates, Pa | Optometrist | 110 Evergreen Square, Pine City, MN 55063 | 2006-07-08 |
| 1053372656 | Kristie Ann Roberts | Dentist | 1105 Hillside Ave Sw, Pine City, MN 55063 | 2006-03-31 |
| 1114495827 | Kelly Ann Buchta | Social Worker | 220 Railroad St Se, Pine City, MN 55063 | 2018-11-12 |
| Find all providers in zip 55063 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669837340 | Kathryn Marvin | Nurse Practitioner | 100 Evergreen Sq Sw, Pine City, MN 55063-2000 | 2015-12-22 |
| 1790877611 | Julie Dorsey Boersen | Nurse Practitioner | 1243 Pennsylvania Ave, Pine City, NY 14871-9230 | 2006-09-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508466368 | Amalia Jo Folland Harvey | Nurse Practitioner | 19883 Evensong Ct, Farmington, MN 55024-8688 | 2020-10-29 |
| 1710586235 | Jackelyn Laura Peterson | Nurse Practitioner | 10101 Bren Rd E Unit 345, Minnetonka, MN 55343-0060 | 2020-10-26 |
| 1578162509 | Mckenzie Mcadaragh | Nurse Practitioner | 10924 Girard Curve, Bloomington, MN 55431 | 2020-10-21 |
| 1861091704 | Morgan Rohl | Nurse Practitioner | 117 12th Ave Nw Apt 2, Rochester, MN 55901-2787 | 2020-10-21 |
| 1063010304 | Kalie R Mccauley | Nurse Practitioner | 11452 Brook Rd Nw, Elk River, MN 55330-8739 | 2020-10-09 |
| 1659978930 | Sarah Jean Mudge | Nurse Practitioner | 350 Harbor Dr, Duluth, MN 55802-2600 | 2020-10-08 |
| 1285231621 | Karlu Dorleh | Nurse Practitioner | 14151 Territorial Rd Unit 212, Maple Grove, MN 55369-5725 | 2020-10-08 |
| 1447857669 | Kimberly Dawn Bursch-tewalt | Nurse Practitioner | 11884 237th Ave Nw, Elk River, MN 55330-8255 | 2020-10-01 |
| 1639786312 | Peter Wahl | Nurse Practitioner | 4652 Lyndale Ave S, Minneapolis, MN 55419-5302 | 2020-09-28 |
| 1568078616 | Joanna Kay Rehm | Nurse Practitioner | 3025 Eagandale Pl Apt 338, Eagan, MN 55121-1236 | 2020-09-23 |
| Find all providers with the same taxonomy | ||||
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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.