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

Nicholas Moore Southerton, MSN, CNP

Individual provider Nurse Practitioner · NPI 1013691153

Nicholas Moore Southerton, MSN, CNP is a Nurse Practitioner in Stillwater, Minnesota. Qualified in 2023, 3 years ago. Practices with Bluestone Physician Services PA, a 59-clinician group and accepts Medicare assignment. Licensed in Minnesota.

Years since qualifying
3
Licensed in
MN
In the registry since
2023
Specialties on file
4
What do these letters mean?
MSN — Master of Science in Nursing
A graduate nursing degree, usually held alongside an advanced practice licence.
CNP — Certified Nurse Practitioner
A certified nurse practitioner.

See every abbreviation used in this directory →

Claim this listing Report a problem Suggest an edit

Practice location Address checks out

270 Main St N Ste 300
Stillwater, MN 55082-6788
Phone: (651) 342-1039
Fax: (651) 342-1428
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

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

Specialties & licences

Gerontology Nurse Practitioner (primary) Taxonomy 363LG0600X · Licence 10301 (MN)
Nurse Practitioner Taxonomy 363L00000X · Licence 10301 (MN)
Adult Health Nurse Practitioner Taxonomy 363LA2200X · Licence 10301 (MN)
Primary Care Nurse Practitioner Taxonomy 363LP2300X · Licence 10301 (MN)

Record details

NPI number1013691153
Entity typeIndividual (Type 1)
GenderMale
Credentials MSN , CNP
Sole proprietorNo
NPI enumeratedJune 9, 2023
Last updated in NPPESMay 4, 2026
Certification dateMay 4, 2026

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Group practice Bluestone Physician Services Pa — 59 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Stillwater