Southerton, Nicholas Moore

Southerton, Nicholas Moore is an individual health care provider with primary practice located at 270 Main St N Ste 300 , Stillwater MN 55082-6788. He recently has 4 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, Physician Assistants & Advanced Practice Nursing Providers / Adult Health, Physician Assistants & Advanced Practice Nursing Providers / Primary Care, Physician Assistants & Advanced Practice Nursing Providers / Gerontology. Physician Assistants & Advanced Practice Nursing Providers / Gerontology is his primary health care specialty. Southerton, Nicholas Moore can be contacted via phone (651) 342-1039.

Contact Information

Primary practice address
270 Main St N Ste 300 Stillwater MN 55082-6788
Phone: (651) 342-1039
Fax: (651) 342-1428
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 10301 Minnesota
Physician Assistants & Advanced Practice Nursing Providers / Adult Health 363LA2200X 10301 Minnesota
Physician Assistants & Advanced Practice Nursing Providers / Primary Care 363LP2300X 10301 Minnesota
Physician Assistants & Advanced Practice Nursing Providers / Gerontology 363LG0600X 10301 Minnesota

Profile Details

NPI number 1013691153
LBN Legal business name Southerton, Nicholas Moore
Credentials MSN, CNP
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 9th, 2023
Last updated May 4th, 2026 - about 5 months 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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