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

Nathaniel James Robert Moore

Individual provider Athletic Trainer · NPI 1104407451

Nathaniel James Robert Moore is an Athletic Trainer in Apple Valley, Minnesota. Practices as a sole proprietor. Registered with an NPI since 2021.

In the registry since
2021

Practice location Address checks out

15957 Firtree Dr
Apple Valley, MN 55124-5834
Phone: (612) 558-4112
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Athletic Trainer (primary) Taxonomy 2255A2300X

Record details

NPI number1104407451
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedApril 19, 2021
Last updated in NPPESApril 19, 2021
Certification dateApril 19, 2021
Mailing address15957 Firtree Dr, Apple Valley, MN 55124-5834

Other providers in Apple Valley