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

Kellyanna J Moore, MD

Individual provider Family Medicine Physician · NPI 1538120746

Kellyanna J Moore, MD is a Family Medicine Physician in Owatonna, Minnesota. Licensed in Minnesota. Registered with an NPI since 2006.

Licensed in
MN
In the registry since
2006
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

2200 NW 26th St
Owatonna, MN 55060-5503
Phone: (507) 451-1120
Fax: (507) 444-6287
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 44578 (MN)

Record details

NPI number1538120746
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorNo
NPI enumeratedMarch 29, 2006
Last updated in NPPESOctober 25, 2024
Certification dateOctober 25, 2024

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