AMANDA M MOEN (NPI# 1154563401) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154563401 |
| Entity Type | Individual |
| Full Name | AMANDA M MOEN |
| Credential | MD |
| Practice Address |
2450 Riverside Ave Minneapolis MN 55454-1450 |
| Mailing Address |
200 University Ave E Saint Paul MN 55101-2507 |
| Practice Telephone | 6123656777 |
| Practice Fax Number | 6123658021 |
| Mailing Telephone | 6517202803 |
| Mailing Fax Number | 6512291718 |
| Enumeration Date | 2009-04-01 |
| Last Update Date | 2019-04-04 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084N0402X |
Psychiatry & Neurology Specialization: Neurology with Special Qualifications in Child Neurology |
58414 | MN | Allopathic & Osteopathic Physicians |
| N | 2084N0402X |
Psychiatry & Neurology Specialization: Neurology with Special Qualifications in Child Neurology |
107634 | MN | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 200 University Ave E, Saint Paul, MN 551012507 | 6517202803 | 6512291718 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437700499 | Amanda Sue Moen | Custodial Care Facility | 700 105th St Nw, Rice, MN 56367-8656 | 2019-09-21 |
| 1720570773 | Amanda Lynn Moen | Student in an Organized Health Care Education/Training Program | 707 N Broadway, Baltimore, MD 21205-1832 | 2018-06-05 |
| Street Address |
2450 RIVERSIDE AVE |
| City | MINNEAPOLIS |
| State | MN |
| Zip Code | 55454-1450 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568462570 | Sreejaya Veluvali | Psychiatry & Neurology | 2450 Riverside Ave, Minneapolis, MN 55454-1450 | 2005-08-01 |
| 1588265375 | Fairview Health Services | General Acute Care Hospital | 2450 Riverside Ave, Minneapolis, MN 55454-1450 | 2020-11-06 |
| 1215535927 | Katrina Joelle Christian | Student in an Organized Health Care Education/Training Program | 2450 Riverside Ave, Department of Pediatrics, 6 East Building, Minneapolis, MN 55454-5510 | 2020-10-14 |
| 1023616208 | Jodi Renee Nelson | Psychologist | 2450 Riverside Ave, Minneapolis, MN 55454-1450 | 2020-10-11 |
| 1912504150 | Pamela Norling | Counselor | 2450 Riverside Ave, Minneapolis, MN 55454-1450 | 2020-10-01 |
| 1225635345 | Trevor Ryan Goldsmith | Nurse Anesthetist, Certified Registered | 2450 Riverside Ave, Minneapolis, MN 55454-1450 | 2020-10-01 |
| 1215534342 | Michelle L White | Marriage & Family Therapist | 2450 Riverside Ave, Attn: Adult Cd Lodging Plus, Minneapolis, MN 55454-1450 | 2020-10-01 |
| 1295341048 | Tobias Zander Donlon | Student in an Organized Health Care Education/Training Program | 2450 Riverside Ave, Minneapolis, MN 55454-1450 | 2020-09-17 |
| 1417562497 | Megan Farr | Dietitian, Registered | 2450 Riverside Ave, Minneapolis, MN 55454-1450 | 2020-09-15 |
| 1871101238 | Fairview Express Care | General Practice | 2450 Riverside Ave, Minneapolis, MN 55454-1450 | 2020-07-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194341842 | Bruce Zhang | Student in an Organized Health Care Education/Training Program | 606 24th Ave. S. Suite 200, Minneapolis, MN 55454 | 2020-06-18 |
| 1205456738 | Sara Segner | Student in an Organized Health Care Education/Training Program | Peds Education Office M136, 1st Floor, East Building, 2450 Riverside Ave, Minneapolis, MN 55454 | 2020-04-24 |
| 1417576844 | Sabena Khan | Student in an Organized Health Care Education/Training Program | M136, 1st Floor, East Building. 2450 Riverside Avenue, Minneapolis, MN 55454 | 2020-04-15 |
| 1811525983 | Kayla Joy Solstad | Student in an Organized Health Care Education/Training Program | M136, 1st Floor, East Bldg., 2450 Riverside Ave, Minneapolis, MN 55454 | 2020-04-01 |
| 1720647126 | Lauren Harasymiw | Student in an Organized Health Care Education/Training Program | Pediatrics Ed. Office, M136, 1st Floor, East Building, 2450 Riverside Ave, Minneapolis, MN 55454 | 2019-06-10 |
| 1689237448 | Katelyn Marie Adams | Student in an Organized Health Care Education/Training Program | Pediatrics Education Office, M136, 1st Floor, East Building, 8950a, 2450 Riverside Ave, Minneapolis, MN 55454 | 2019-04-17 |
| 1285197848 | Adrienne Bruder | Student in an Organized Health Care Education/Training Program | M136, 1st Floor, East Building, 8950a, 2450 Riverside Ave, Minneapolis, MN 55454 | 2019-04-10 |
| 1588142855 | Stewart Graeme Morrison | Student in an Organized Health Care Education/Training Program | Department of Orthopaedics University of Minnesota, 2450 Riverside Ave R200, Minneapolis, MN 55454 | 2018-07-30 |
| 1831682251 | Sherab Tsheringla | Student in an Organized Health Care Education/Training Program | 2450 Riverside Avenue South, Minneapolis, MN 55454 | 2018-06-11 |
| 1669962148 | Pooja Elizabeth Mishra | Student in an Organized Health Care Education/Training Program | M136, 1st Floor, East Building 8950a (campus Delivery C, 2450 Riverside Ave, Minneapolis, MN 55454 | 2018-05-10 |
| Find all providers in zip 55454 | ||||
| Taxonomy Code | 2084N0402X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Neurology with Special Qualifications in Child Neurology |
| A Child Neurologist specializes in neurology with special skills in diagnosis and treatment of neurologic disorders of the neonatal period, infancy, early childhood, and adolescence. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154607489 | Janet Elgallab | Psychiatry & Neurology | 2828 Chicago Ave Ste 200, Minneapolis, MN 55407-1544 | 2011-11-01 |
| 1306092655 | Laura Catherine Speltz | Psychiatry & Neurology | 2512 S 7th St, Minneapolis, MN 55454-1404 | 2008-08-18 |
| 1790997393 | Sonya Grace Wang | Psychiatry & Neurology | 5775 Wayzata Blvd Ste 255, Minneapolis, MN 55416-1275 | 2007-05-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346735750 | Hicham Dabaja | Psychiatry & Neurology | 200 1st St Sw, Rochester, MN 55905-0001 | 2018-06-27 |
| 1205200383 | Child Neurology Solutions Pllc | Psychiatry & Neurology | 360 Sherman St, Suite 399, Fort Road Medical Center, Saint Paul, MN 55102-2564 | 2015-11-30 |
| 1962829432 | Jamie Marie Eskuri | Psychiatry & Neurology | 200 University Ave E, Saint Paul, MN 55101-2507 | 2014-03-23 |
| 1154587863 | Nitin Agarwal | Psychiatry & Neurology | 225 Smith Ave N, Saint Paul, MN 55102-2533 | 2008-08-01 |
| 1134318488 | Nicole Jeanette Williams Doonan | Psychiatry & Neurology | 200 University Ave E, Saint Paul, MN 55101-2507 | 2007-10-22 |
| 1740360734 | Beverly S Wical | Psychiatry & Neurology | 200 University Ave E, Saint Paul, MN 55101-2507 | 2006-10-16 |
| 1043309172 | Betty J Ong | Psychiatry & Neurology | 200 University Ave E, Saint Paul, MN 55101-2507 | 2006-10-12 |
| 1467561464 | Timothy Feyma | Psychiatry & Neurology | 200 University Ave E, Office 3344, Saint Paul, MN 55101-2507 | 2006-08-30 |
| 1578571436 | Michael D Frost | Psychiatry & Neurology | 225 Smith Ave N, Suite 201, Saint Paul, MN 55102-2697 | 2006-08-04 |
| 1710908447 | Jason S Doescher | Psychiatry & Neurology | 225 Smith Ave N, Suite 201, Saint Paul, MN 55102-2697 | 2006-07-21 |
| Find all providers with the same taxonomy | ||||
| City | MINNEAPOLIS |
| Zip Code | 55454 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.