Moore, Lavonne M

Moore, Lavonne M is an individual health care provider with primary practice located at 1313 Penn Avenue North , Minneapolis MN 55441. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife. Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner is her primary health care specialty. Moore, Lavonne M can be contacted via phone (612) 543-2500.

Contact Information

Primary practice address
1313 Penn Avenue North Minneapolis MN 55441
Phone: (612) 543-2500
Fax: (612) 302-4870
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X R1138272 Minnesota
Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife 367A00000X R113827-2 Minnesota

Profile Details

NPI number 1750348546
LBN Legal business name Moore, Lavonne M
Credentials RNC CNM
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 27th, 2006
Last updated Feb 26th, 2013 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1750348546 NPPES
Minnesota MEDICAID 702615300

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