Individual
KAITLYN MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
411 STAGELINE RD STE 200, HUDSON, WI 54016-7848
(715) 531-6700
Mailing address
8327 AFTON RD, WOODBURY, MN 55125-9656
(651) 373-6128
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
14280-33
WI
Other
Enumeration date
08/02/2023
Last updated
08/02/2023
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