Individual provider · Type 1 NPI

Nicolle Marie Moore, NP-C

Nurse Practitioner · Dakota Dunes, SD

NPI number 1053984500 Active

Practice location

317 Dakota Dunes Blvd Ste D
Dakota Dunes, SD 57049-5341

Fax (605) 599-7105

Specialties and licenses

TaxonomyCodeLicense
Nurse Practitioner Primary 363L00000XA164738 (IA)

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 wit…

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About NPI 1053984500

Nicolle Marie Moore, NP-C's National Provider Identifier is 1053984500, issued on Jul 22, 2021. The primary taxonomy on file is Nurse Practitioner (363L00000X), and the practice location is in Dakota Dunes, SD. The record was last updated on Sep 22, 2026.