IndividualActive
Amanda Moen, MD
NPI 1154563401 · Neurology with Special Qualifications in Child Neurology Physician · Minneapolis, MN
Provider details
- NPI number
- 1154563401
- Entity type
- Individual
- Primary specialty
- Neurology with Special Qualifications in Child Neurology PhysicianAllopathic & Osteopathic Physicians
- Credential
- MD
- Sex
- Female
- Sole proprietor
- No
- License
- 107634 (MN)
Specialties & taxonomies
- Neurology with Special Qualifications in Child Neurology PhysicianPrimary2084N0402XLicense 58414 (MN)
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
Practice location
2450 Riverside Ave
Minneapolis, MN 55454-1450
Phone: (612) 365-6777
Fax: (612) 365-8021
Approximate (ZIP-level) locationGet directions
Mailing address
200 University Ave E
Saint Paul, MN 55101-2507
Additional practice locations (1)
- 200 University Ave ESaint Paul, MN 55101-2507Phone: (651) 720-2803Fax: (651) 229-1718
Registry dates
- Enumerated
- 2009-04-01
- Last updated
- 2019-04-04
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.