Individual
SARA NIKOLAI MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
14700 28TH AVE N STE 20, PLYMOUTH, MN 55447-4876
(763) 559-3779
Mailing address
PO BOX 47159, PLYMOUTH, MN 55447-0159
(763) 559-3779
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
2891
MN
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
08/18/2023
Last updated
03/18/2026
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