Individual
MS. CAROL SUE MOEN
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
524 4TH AVE NE, UNIT 9, DEVILS LAKE, ND 58301-2490
(701) 662-7046
Mailing address
5312 118TH AVE NE, MICHIGAN, ND 58259-9452
(701) 259-2339
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
R20055
ND
Other
Enumeration date
04/03/2006
Last updated
07/08/2007
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