Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | 68246 | MN |
N | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | 68246 | MN |
N | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | MD-40186 | IA |
N | 207VX0000X | Obstetrician | 40186 | IA |
NPI | 1326207572 |
---|---|
Provider Name | Nina N Moreira |
First Address | St Louis Park, MN 55426-5000 |
Second Address | St Louis Park, MN 55426-5000 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/06/2008 |
Last Update Date | 25/11/2020 |