Individual
MRS. KATIE MARIE MOEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
6110 S MINNESOTA AVE, SIOUX FALLS, SD 57108-2549
(605) 332-2883
Mailing address
PO BOX 5074, SIOUX FALLS, SD 57117-5074
(605) 328-6585
Taxonomy
Speciality
Code
Description
License number
State
163WE0003X
Emergency Registered Nurse
R047682
SD
363L00000X
Nurse Practitioner
Primary
CP002201
SD
Other
Enumeration date
09/10/2021
Last updated
05/26/2022
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