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Contact Information

LAVONNE M MOORE, RNC CNM
1313 PENN AVENUE NORTH
MINNEAPOLIS, MN55441
 Phone: 612-543-2500
 Fax: 612-302-4870
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Nurse Practitioner

363L00000X 50 Nurse Practitioner
 

Advanced Practice Midwife

367A00000X 42 Certified Nurse Midwife
Indicates primary specialty

NPI Profile & details for LAVONNE M MOORE · (Female)

NPI # 1750348546
Status Active
Credentials RNC CNM
Entity Individual
Enumeration date 04/27/2006
Last updated 02/26/2013 - About 13 years ago
Sole proprietor 1 No
Identifiers
  • MN License # R113827-2
  • MN License # R1138272
  • MN Medicaid 702615300
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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