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HAVONA MOORE
NPI 1174475040
Licensed Practical Nurse in Maplewood, MN

Active since February 12, 2026
3100 KENNARD ST, MAPLEWOOD, MN 55109(651) 225-5456 Get Directions Write a Review

NPPES record last updated: February 12, 2026. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Havona Moore NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

HAVONA MOORE (NPI 1174475040) is an individual licensed practical nurse in Maplewood, Minnesota, licensed in Minnesota (L-625029) and active in the NPI registry since February 2026.

NPPES Registry Identity

NPI1174475040
Entity TypeIndividualFemale
Primary Taxonomy164W00000X
Provider Legal NameHAVONA MOORE
Location Address3100 KENNARD STMaplewood, MN 55109-5465
Mailing Address3100 Kennard StMaplewood, MN 55109-5465
Phone(651) 225-5456
Sole ProprietorNo
Enumeration DateFebruary 12, 2026
NPPES CertifiedFebruary 12, 2026
✔ NPI 1174475040 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyLicensed Practical NurseNursing Service Providers
Taxonomy Code164W00000X
License✔ Licensed in MN · L-625029
Definition

A licensed practical nurse with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states.

3100 KENNARD ST, Maplewood, MN 55109
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Other Providers at the Same Location NPPES 10

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. KENT DAVIS BERGH M.D.
Family Medicine
3100 KENNARD ST, SUITE 100 HEALTHEAST PHYSICIAN SERVICE,
MAPLEWOOD, MN 55109
Ramsey County (651) 232-7800
DR. STEPHANIE J FOX MD
Allergy & Immunology
3100 KENNARD ST
MAPLEWOOD, MN 55109
Ramsey County (651) 326-1044
HEALTHEAST CARE SYSTEM
Non-Pharmacy Dispensing Site
3100 KENNARD ST, 100
MAPLEWOOD, MN 55109
Ramsey County (651) 232-7800
CHRISTOPHER NEVILLE USSHER M.D.
Internal Medicine (Rheumatology)
3100 KENNARD ST
MAPLEWOOD, MN 55109
Ramsey County (650) 737-2692
THOMAS GROVE WILSON CNP
Nurse Practitioner (Primary Care)
3100 KENNARD ST, SUITE 100
MAPLEWOOD, MN 55109
Ramsey County (651) 232-7800
DR. CAROL LU MD
Internal Medicine
3100 KENNARD ST, STE 100
MAPLEWOOD, MN 55109
Ramsey County (651) 232-7800
GEORGIANN MARIE MELTON PSYCHOTHERAPIST
Counselor (Addiction (Substance Use Disorder))
3100 KENNARD ST
MAPLEWOOD, MN 55109
Ramsey County (612) 356-4634
MRS. ALYSSA RAE WILLIAMS LPN
Licensed Practical Nurse
3100 KENNARD ST
MAPLEWOOD, MN 55109
Ramsey County (651) 225-5420

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Havona Moore's NPI number?

The NPI number for Havona Moore is 1174475040. It was assigned to this individual provider in the NPPES registry on February 12, 2026.

Where is Havona Moore located?

Havona Moore practices at 3100 Kennard St, Maplewood, MN 55109. The listed phone number is (651) 225-5456.

What is Havona Moore's specialty?

The primary specialty registered for this NPI is Licensed Practical Nurse with taxonomy code 164W00000X.

When was this NPI record last updated?

The NPPES record for Havona Moore was last updated on February 12, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.