MEDICARE: DANIEL MOEGI APRN, CNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	8351	MN

General Provider Information

NPI Number	:	1508534751
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANIEL MOEGI APRN, CNP

Provider Business Mailing Address
First Line	:	3200 LABORE RD STE 104
Second Line	:
City	:	VADNAIS HEIGHTS
State	:	MN
Zip	:	55110-5186
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	400 4TH ST NW STE A
Second Line	:
City	:	FARIBAULT
State	:	MN
Zip	:	55021-5090
Country	:	US
Telephone Number	:	507-384-6830
Fax Number	:	651-431-7757

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/02/2021
Last Update Date	:	03/03/2026

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