Nicholas Moore Southerton
MSN, CNP | Nurse Practitioner
270 Main St N Ste 300, Stillwater
Minnesota, 55082-6788
651-342-1039
Nicholas Moore Southerton is a Stillwater, Minnesota based nurse practitioner. Active license number of Nicholas Moore Southerton is 10301 for Gerontology in Minnesota. His current practice location is 270 Main St N Ste 300, Stillwater. Patients can reach him at 651-342-1039 or can fax him at 651-342-1428. Nicholas Moore Southerton is MSN, CNP and his NPI number (Unique professional ID assigned by NPPES) is 1013691153.
Nicholas Moore Southerton has completed additional training beyond basic nursing education and provides primary health care services in accordance with state nurse practice laws or statutes. NPs are trained to assess patient needs, order and interpret diagnostic and laboratory tests, diagnose disease, formulate and prescribe medications and treatment plans.
Complete Profile:
Nicholas Moore Southerton speciality, credentials, practice address, contact phone number and fax are as below.
Patients can call on the below given phone number for appointment.
| Name: | Nicholas Moore Southerton |
| Specialization: | Nurse Practitioner (NP) |
| Gender: | Male |
| Credentials: | MSN, CNP |
| Practice Address: | 270 Main St N Ste 300, Stillwater,
Minnesota, 55082-6788 |
| Phone: | 651-342-1039 |
| Fax: | 651-342-1428 |
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details are as mentioned below.
| NPI Number: | 1013691153 |
| NPI Enumeration Date: | 09 Jun, 2023 |
| NPI Last Update On: | 10 Jan, 2025 |
Medical Licenses:
NPs can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Nicholas Moore Southerton are as mentioned below.
| License Number | Specialization | State | Status | |
| 10301 | Gerontology | Minnesota | Primary | |
| 10301 | Nurse Practitioner | Minnesota | Secondary | |
| 10301 | Adult Health | Minnesota | Secondary | |
| 10301 | Primary Care | Minnesota | Secondary | |
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
| Address: | Nicholas Moore Southerton
2124 144th Ln Ne,
Ham Lake, Minnesota |
| Zip: | 55304-6260 |
| Phone Number: | 763-248-4011 |
Patients can reach Nicholas Moore Southerton at
270 Main St N Ste 300, Stillwater, Minnesota or can
call to book an appointment on 651-342-1039.
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Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 13 October, 2025.