person
Nicholas Moore Southerton, CNP
Gerontology Nurse Practitioner in Minneapolis, Minnesota
NPI 1013691153

Nicholas Moore Southerton is a Gerontology Nurse Practitioner based in Ham Lake, MN and is specialized in Gerontology. Nicholas Moore Southerton practices in Minneapolis, MN and has the professional credentials of CNP. The NPI Number for Nicholas Moore Southerton is 1013691153 and holds a License No. 10301 (Minnesota).

The current practice location address for Nicholas Moore Southerton is 1415 Lilac Dr N, Minneapolis, MN and can be reached out via phone at 763-205-4168.

Location: 1415 Lilac Dr N, Minneapolis, MN, 55304-6260
person
Provider Profile Details
NPI Number
1013691153
Provider Name
Nicholas Moore Southerton
Credential
CNP
Provider Entity Type
Individual
Gender
Male
Address
1415 Lilac Dr N, Minneapolis, MN, 55304-6260
Phone Number
763-205-4168
Fax Number
Provider Enumeration Date
06/09/2023
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
1415 Lilac Dr N
City
State
Zip
55422-4500
Phone Number
763-205-4168
Fax Number
person
Provider Business Mailing Address Details
Address
1415 Lilac Dr N
City
State
Zip
55422-4500
Phone Number
763-205-4168
Fax Number
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Gerontology
Taxonomy
License No.
10301 (Minnesota)
Definition
Definition to come...
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