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

Lavonne M Moore, RNCCNM

Individual provider Nurse Practitioner · NPI 1750348546

Lavonne M Moore, RNCCNM is a Nurse Practitioner in Minneapolis, Minnesota. Qualified in 2003, 23 years ago. Practices with Hennepin County, a 132-clinician group and accepts Medicare assignment. Licensed in Minnesota.

Years since qualifying
23
Licensed in
MN
In the registry since
2006
Specialties on file
2
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Practice location Address checks out

1313 Penn Ave N
Minneapolis, MN 55441
Phone: (612) 543-2500
Fax: (612) 302-4870
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence R1138272 (MN)
Advanced Practice Midwife Taxonomy 367A00000X · Licence R113827-2 (MN)

Record details

NPI number1750348546
Entity typeIndividual (Type 1)
GenderFemale
Credentials RNCCNM
Sole proprietorNo
NPI enumeratedApril 27, 2006
Last updated in NPPESFebruary 26, 2013

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2003 (23 years in practice)
Group practice Hennepin County — 132 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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