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Individual

MS. CATHERINE ANN MOE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
ACNS- BC, CWOCN

Contact information

Practice address
301 BECKER AVE SW, WILLMAR, MN 56201-3302
(320) 295-8899
Mailing address
812 17TH ST SW, WILLMAR, MN 56201-2836
(320) 235-9704

Taxonomy

Speciality
Code
Description
License number
State
163WC2100X
Continence Care Registered Nurse
R087309-1
MN
163WW0000X
Wound Care Registered Nurse
R087309-1
MN
163WX1500X
Ostomy Care Registered Nurse
R087309-1
MN
364SA2200X
Adult Health Clinical Nurse Specialist
Primary
0362703
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
256L0MO
BLUE CROSS BILING NO.
MN
01
890000407
PROVIDER TRANSACTION ACCESS NUMBER (PTAN)
MN
Enumeration date
04/24/2007
Last updated
12/05/2011
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