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Organization

EAGAN CHILD AND FAMILY CARE, P.A.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
GRETCHEN A MOEN CPNP (PRESIDENT)
(651) 209-8640
Entity
Organization

Contact information

Practice address
4178 KNOB DR, SUITE A, EAGAN, MN 55122-2888
(651) 209-8640
(651) 209-8690
Mailing address
4178 KNOB DR, SUITE A, EAGAN, MN 55122-2888
(651) 209-8640
(651) 209-8690

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
1650
MN
208000000X
Pediatrics Physician
Primary
1650
MN
363LF0000X
Family Nurse Practitioner
1650
MN
363LP0200X
Pediatric Nurse Practitioner
1650
MN
363LW0102X
Women's Health Nurse Practitioner
1650
MN

Other

Enumeration date
07/07/2006
Last updated
09/11/2025
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