LISA R MOEN (NPI# 1982955159) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1982955159 |
| Entity Type | Individual |
| Full Name | LISA R MOEN |
| Other Name | LISA HOFFARTH |
| Credential | NP-C |
| Practice Address |
1702 University Dr S Fargo ND 58103-4940 |
| Mailing Address |
Po Box 6001 Fargo ND 58108-6001 |
| Practice Telephone | 7013643300 |
| Practice Fax Number | 7013648906 |
| Mailing Telephone | 7013643300 |
| Mailing Fax Number | 7013648906 |
| Enumeration Date | 2012-09-27 |
| Last Update Date | 2013-01-04 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | R34505 | ND | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ND | 84203 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184844912 | Lisa Michelle Moen | Social Worker | 2441 Rio Grande Cir, Naperville, IL 60565-3362 | 2007-04-26 |
| 1578080743 | Lisa Moen | Counselor | 1833 3rd Ave, Anoka, MN 55303-2424 | 2017-08-28 |
| 1841592409 | Lisa Elane Moen | Occupational Therapist | 19217 36th Ave W, Suite 102, Lynnwood, WA 98036-5751 | 2010-12-02 |
| Street Address |
1702 UNIVERSITY DR S |
| City | FARGO |
| State | ND |
| Zip Code | 58103-4940 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245223023 | Kimberly Rae Kelly | Dermatology | 1702 University Dr S, Fargo, ND 58103-4940 | 2005-08-26 |
| 1467060046 | Jessica Marie Munro | Optometrist | 1702 University Dr S, Fargo, ND 58103-4940 | 2020-07-20 |
| 1972132249 | Kalee Irene Wysuph | Student in an Organized Health Care Education/Training Program | 1702 University Dr S, Fargo, ND 58103-4940 | 2020-04-07 |
| 1699314617 | April M Sweet | Nurse Practitioner | 1702 University Dr S, Fargo, ND 58103-4940 | 2019-12-23 |
| 1427603588 | Annelise Sterneman | Nurse Practitioner | 1702 University Dr S, Fargo, ND 58103-4940 | 2019-08-06 |
| 1518511799 | Morgan A Schmitz | Nurse Practitioner | 1702 University Dr S, Fargo, ND 58103-4940 | 2019-07-26 |
| 1093367799 | Josalyn J Grueneich | Nurse Practitioner | 1702 University Dr S, Fargo, ND 58103-4940 | 2019-07-12 |
| 1295395176 | Amanda J Coronato | Occupational Therapist | 1702 University Dr S, Fargo, ND 58103-4940 | 2019-06-13 |
| 1962976068 | Moriah M Anderson | Dietitian, Registered | 1702 University Dr S, Fargo, ND 58103-4940 | 2019-01-11 |
| 1811489743 | Karli Lenae Roman | Nurse Practitioner | 1702 University Dr S, Fargo, ND 58103-4940 | 2018-06-06 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659924843 | Amanda Hericks | Dentist | 1338 Gateway Drive S, Fargo, ND 58103 | 2019-07-17 |
| 1285298240 | Ann Louise Breen | Optometrist | Sanford Southpointe Eye Center & Optical, 2400 32nd Ave. S., Fargo, ND 58103 | 2019-04-25 |
| 1245706597 | Lisa Elaine Livingston | Counselor | 1337 14 and Half St. S., Fargo, ND 58103 | 2018-10-15 |
| 1528569662 | Misty Lynn Hagen | Counselor | 901 28th St. South, Suite B, Fargo, ND 58103 | 2018-02-23 |
| 1083133011 | Faith Homecare Professionals LLC | Home Health | 304 25th St S, Suite B, Fargo, ND 58103 | 2017-09-11 |
| 1982138749 | Matthew Troyer | Pharmacist | 2425 13th Ave, Fargo, ND 58103 | 2017-04-18 |
| 1801338504 | Amy Nguyen Christianson | Chiropractor | 1650 45th St S Ste 113, Fargo, ND 58103 | 2016-11-11 |
| 1245772359 | Andrea Marie Hanson | Nurse Practitioner | 2400 32nd Ave South, Fargo, ND 58103 | 2016-11-07 |
| 1831647940 | Abigail Carmen Burkett Vetter | Nurse Practitioner | 2928 University Dr S Suite 101, Fargo, ND 58103 | 2016-09-18 |
| 1013361302 | Nancy Knowlton | Speech-Language Pathologist | 3001 11th Ave S, Beyond Boundaries Speech-language, Fargo, ND 58103 | 2016-04-22 |
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| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003472317 | Sadie Marie Nelson | Nurse Practitioner | Sanford Broadway Clinic, 801 North Broadway, Fargo, ND 58102 | 2019-05-13 |
| 1245772359 | Andrea Marie Hanson | Nurse Practitioner | 2400 32nd Ave South, Fargo, ND 58103 | 2016-11-07 |
| 1437565330 | Christina Dahl | Nurse Practitioner | 1665 43rd St S Ste 102, Fargo, ND 58103-3316 | 2014-07-11 |
| 1003242256 | Wendy M Moore | Nurse Practitioner | 901 28th St S, Fargo, ND 58103 | 2013-09-19 |
| 1043599277 | Rebecca Ann Kiecker | Nurse Practitioner | 1720 South University Drive, Sanford South University, Fargo, ND 58103 | 2011-08-05 |
| 1780832634 | Sarah M Baker | Nurse Practitioner | 3274 51st St S, Fargo, ND 58104 | 2008-09-04 |
| 1932207149 | Carlee N Leininger | Nurse Practitioner | 2301 25th St S Ste A, Fargo, ND 58103-6104 | 2006-09-20 |
| 1780607788 | Casey M Hoover | Nurse Practitioner | Rejuv Medical Aesthetic Clinic, 3301 45th St S, Fargo, ND 58103 | 2006-07-25 |
| 1023030517 | Tina M Lundeen | Nurse Practitioner | 600 4th St S, Fargo, ND 58103-2804 | 2006-07-24 |
| 1992727481 | Melissa R Erdmann | Nurse Practitioner | 827 28th St S, Unit B, Fargo, ND 58103-8727 | 2006-07-24 |
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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.