Carol Sue Moen, NURSE PRACTITIONER

Primary specialty

Women's Health Nurse PractitionerTaxonomy code 363LW0102X

License

R20055 Issued in ND

Practice address

524 4TH Ave NE
Unit 9
Devils Lake, ND 58301-2490

Phone

(701) 662-7046

NPI assigned

Apr 3, 2006

Sex

Female

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

Medicare enrollment (NPD)

Not enrolled

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.

• Lake Region District Health Unit

  • Public Health or Welfare Agency
  • Devils Lake, ND
  • NPI 1164553160
  NPD (past)
• Lake Region Family Planning Program

  • Public Health or Welfare Agency
  • Devils Lake, ND
  • NPI 1407068778
  NPD (past)

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

{
    "created_epoch": "1144022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1619939006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5312 118TH AVE NE",
            "city": "MICHIGAN",
            "state": "ND",
            "postal_code": "582599452",
            "telephone_number": "701-259-2339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "524 4TH AVE NE",
            "address_2": "UNIT 9",
            "city": "DEVILS LAKE",
            "state": "ND",
            "postal_code": "583012490",
            "telephone_number": "701-662-7046"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOEN",
        "first_name": "CAROL",
        "middle_name": "SUE",
        "name_prefix": "Ms.",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-03",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "ND",
            "license": "R20055",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mercy Hospital of Devils Lake (CHI St Alexius Health Devils Lake)
• Jamie L Miller
• Jocelyn Nicole Miller
• Louise Mitzel
• Amber Gayle Moen
• Dorothy Elizabeth Moen
• Mark A Moen, OD
• Russell Moen
• Sheila Moen
• Roberto A. Moraleda, M.D.

• Women's Health Nurse Practitioner in Devils Lake, ND
• Providers in Devils Lake, ND by specialty
• Women's Health Nurse Practitioner in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.