| Sandra J Moore, NP | |
|
1425 Main St N, Pine City, MN 55063-6026 | |
| (320) 629-7505 | |
| (320) 629-2202 |
| Full Name | Sandra J Moore |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner |
| Experience | 18 Years |
| Location | 1425 Main St N, Pine City, Minnesota |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851510366 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363L00000X | Nurse Practitioner | 157868 (Wisconsin) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | R 181983-4 (Minnesota) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Firstlight Health System | Mora, MN | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Welia Health | 6709295496 | 43 |
| Entity Name | County Of Kanabec |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1528031390 PECOS PAC ID: 0648187237 Enrollment ID: O20031125000660 |
| Entity Name | Welia Health |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1528031390 PECOS PAC ID: 6709295496 Enrollment ID: O20220125001227 |
| Mailing Address | Practice Location Address |
|---|---|
| Sandra J Moore, NP 1425 Main St N, Pine City, MN 55063-6026 Ph: (320) 629-7505 | Sandra J Moore, NP 1425 Main St N, Pine City, MN 55063-6026 Ph: (320) 629-7505 |
Melinda Margaret Mckay, DNP, APRN, PMHNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1425 Main St N, Pine City, MN 55063 Phone: 320-629-7505 Fax: 320-225-3507 | |
Kathryn Marvin, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 100 Evergreen Sq Sw, Pine City, MN 55063 Phone: 320-629-6721 | |
Shannon Marie Olson, CNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 410 4th Ave Ne, Pine City, MN 55063 Phone: 320-310-5166 |