Individual
SHARON MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4670 PARK NICOLLET AVE SE, PRIOR LAKE, MN 55372-3908
(952) 993-7750
Mailing address
6465 WAYZATA BLVD, SUITE 315, MINNEAPOLIS, MN 55426-1728
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
R0679525
MN
Other
Enumeration date
12/29/2005
Last updated
03/31/2015
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