Individual
NICHOLAS MOORE SOUTHERTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSN, CNP
Contact information
Practice address
270 MAIN ST N STE 300, STILLWATER, MN 55082-6788
(651) 342-1039
(651) 342-1428
Mailing address
2124 144TH LN NE, HAM LAKE, MN 55304-6260
(763) 248-4011
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
10301
MN
363LA2200X
Adult Health Nurse Practitioner
10301
MN
363LG0600X
Gerontology Nurse Practitioner
Primary
10301
MN
363LP2300X
Primary Care Nurse Practitioner
10301
MN
Other
Enumeration date
06/09/2023
Last updated
05/04/2026
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us