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Individual

STACIE J MOEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP

Contact information

Practice address
4177 S COLUMBIA RD STE 106, GRAND FORKS, ND 58201-7787
(701) 757-3747
(701) 757-3747
Mailing address
606 7TH ST N, THOMPSON, ND 58278-4153
(701) 330-2310
(701) 330-2310

Taxonomy

Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
230520
ND

Other

Enumeration date
11/19/2025
Last updated
11/19/2025
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