Moore, Jacob

Moore, Jacob is an individual health care provider with primary practice located at 1900 Silver Lake Rd Nw Suite 110, New Brighton MN 55112-1786. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Moore, Jacob can be contacted via phone (651) 628-9566.

Contact Information

Primary practice address
1900 Silver Lake Rd Nw Suite 110 New Brighton MN 55112-1786
Phone: (651) 628-9566
Fax: (651) 628-0411
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X Minnesota

Profile Details

NPI number 1851780928
LBN Legal business name Moore, Jacob
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 13th, 2015
Last updated Apr 27th, 2015 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Popular Providers