Victoria Ashley Moeller

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

2475556 Issued in MN

Practice address

3201 128TH Ave NE
Blaine, MN 55449-7536

Phone

(763) 447-9422

NPI assigned

Aug 7, 2019

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1565136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565136000000",
    "number": "1013562966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3201 128TH AVE NE",
            "city": "BLAINE",
            "state": "MN",
            "postal_code": "554497536",
            "telephone_number": "763-447-9422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3201 128TH AVE NE",
            "city": "BLAINE",
            "state": "MN",
            "postal_code": "554497536",
            "telephone_number": "763-447-9422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOELLER",
        "first_name": "VICTORIA",
        "middle_name": "ASHLEY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-08-07",
        "last_updated": "2019-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MN",
            "license": "2475556",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Minnesota Interventional Pain Associates
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• Modern Dental Professionals
• Teneglis C Moe, DC
• Patricia A. Moen, M.S., ATC
• David Moga
• Angie Mohamed, PHARMD
• Asha Mohamed
• Ayan A Mohamed

• Registered Nurse in Blaine, MN
• Providers in Blaine, MN by specialty
• Registered Nurse in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.