Trace Mowers, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

12541 Issued in MN

Practice address

1102 E 4TH St
Duluth, MN 55805-2219

Phone

(218) 310-8896

Fax

(218) 310-8896

NPI assigned

Feb 13, 2025

Sex

Male

Sole proprietor

No

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

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Webmed Mental Health

  • Mental Health Counselor
  • Duluth, MN
  • NPI 1073021036

  Psychiatric/Mental Health

  NPD

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

{
    "created_epoch": "1739404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739404800000",
    "number": "1013712231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1102 E 4TH ST",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558052219",
            "telephone_number": "218-206-9390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1102 E 4TH ST",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558052219",
            "telephone_number": "218-310-8896",
            "fax_number": "218-310-8896"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOWERS",
        "first_name": "TRACE",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-02-13",
        "last_updated": "2025-02-13",
        "certification_date": "2025-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MN",
            "license": "12541",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lily Grace Motzko
• Joseph Edward Mourin
• Moving Forward Afc LLC
• Moving Waters Counseling LLC
• Vani C Movva, MBBS
• MSL-MN Alf Services
• Msocs-Swan Lake
• Jessica Mueller Bouchard, M.A., LPCC
• Kevin Joseph Mueller, O.D.
• Krystal Mueller

• Psychiatric/Mental Health Nurse Practitioner in Duluth, MN
• Providers in Duluth, MN by specialty
• Psychiatric/Mental Health Nurse Practitioner in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.