Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Kathryn Lee Moore, CNP

Individual provider Adult Health Nurse Practitioner · NPI 1538756507

Kathryn Lee Moore, CNP is a Nurse Practitioner in Sioux Falls, South Dakota. Qualified in 2020, 6 years ago. Practices with Avera McKennan, a 962-clinician group and accepts Medicare assignment. Licensed in South Dakota.

Years since qualifying
6
Licensed in
SD
In the registry since
2020
What do these letters mean?
CNP — Certified Nurse Practitioner
A certified nurse practitioner.

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Practice location Address checks out

4500 N Lewis Ave
Sioux Falls, SD 57104-7111
Phone: (605) 322-6368
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Adult Health Nurse Practitioner (primary) Taxonomy 363LA2200X · Licence CP001926 (SD)

Record details

NPI number1538756507
Entity typeIndividual (Type 1)
GenderFemale
Credentials CNP
Sole proprietorNo
NPI enumeratedDecember 24, 2020
Last updated in NPPESDecember 24, 2020
Certification dateDecember 24, 2020

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice Avera McKennan — 962 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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