Kristin Elizabeth Moen, RN, DNP, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

10000600 Issued in OR

Practice address

Center for Developing Hope
2075 NW Grant Ave.
Corvallis, OR 97330

Phone

(541) 368-3152

Fax

(855) 279-0612

NPI assigned

Feb 26, 2016

Last updated

Nov 8, 2022By the provider in NPPES

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

Credentials

Registered Nurse

State licenses

Practice roles

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

• Center for Developing Hope

  • Psychiatric/Mental Health Nurse Practitioner
  • Corvallis, OR
  • NPI 1588227540
  NPD (past)
• Two River Psychiatry

  • Psychiatric/Mental Health Nurse Practitioner
  • Corvallis, OR
  • NPI 1770274979
  NPD (past)

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

{
    "created_epoch": "1456444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667865600000",
    "number": "1093175424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "CENTER FOR DEVELOPING HOPE",
            "address_2": "2075 NW GRANT AVE.",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "97330",
            "telephone_number": "541-368-3152",
            "fax_number": "855-279-0612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CENTER FOR DEVELOPING HOPE",
            "address_2": "2075 NW GRANT AVE.",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "97330",
            "telephone_number": "541-368-3152",
            "fax_number": "855-279-0612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOEN",
        "first_name": "KRISTIN",
        "middle_name": "ELIZABETH",
        "credential": "RN, DNP, PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-02-26",
        "last_updated": "2022-11-08",
        "certification_date": "2022-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OR",
            "license": "10000600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jason Mizak, RBT
• Vanessa Kelly Mizak, FNP-C, AGCNS-BC
• Latu Silatolu Moala
• Sunni M. Modaffari, LPC
• Kathryn L Moen, P.T
• Taylor Moffatt
• Nada Mohamed
• Mohammed S Mohammed, M.D.
• Mojo Physical Therapy LLC
• Shawn Moling, MA

• Psychiatric/Mental Health Nurse Practitioner in Corvallis, OR
• Providers in Corvallis, OR by specialty
• Psychiatric/Mental Health Nurse Practitioner in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2022; 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.