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KOLU SWAH MOORE
NPI 1639970072
Licensed Practical Nurse in Saint Cloud, MN

Active since March 21, 2025
4801 VETERANS DR, SAINT CLOUD, MN 56303(320) 252-1670 Get Directions Write a Review

NPPES record last updated: March 21, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Kolu Swah Moore NPPES

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

KOLU SWAH MOORE (NPI 1639970072) is an individual licensed practical nurse in Saint Cloud, Minnesota, licensed in Minnesota (825170) and active in the NPI registry since March 2025.

NPPES Registry Identity

NPI1639970072
Entity TypeIndividualFemale
Primary Taxonomy164W00000X
Provider Legal NameKOLU SWAH MOORE
Location Address4801 VETERANS DRSaint Cloud, MN 56303-2015
Mailing Address4801 Veterans DrSaint Cloud, MN 56303-2015 · (320) 252-1670
Phone(320) 252-1670
Sole ProprietorNo
Enumeration DateMarch 21, 2025
NPPES CertifiedMarch 21, 2025
✔ NPI 1639970072 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 · 825170
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.
4801 VETERANS DR, Saint Cloud, MN 56303
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Other Providers at the Same Location NPPES 20

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

PATRICIA ANN MEYER LICSW
Social Worker (Clinical)
4801 VETERANS DR
SAINT CLOUD, MN 56303
Stearns County (320) 252-1670
MRS. ANDREA DIXON PHARMD
Pharmacist
4801 VETERANS DR
SAINT CLOUD, MN 56303
Stearns County (320) 252-1670
NICOLE WILLIS
Occupational Therapy Assistant
4801 VETERANS DR
SAINT CLOUD, MN 56303
Stearns County (320) 252-1670
ERIN MAE BRUNTLETT
Specialist/Technologist (Rehabilitation, Blind)
4801 VETERANS DR
SAINT CLOUD, MN 56303
Stearns County (320) 252-1670
HEIDE COUNTER
Licensed Practical Nurse
4801 VETERANS DR
SAINT CLOUD, MN 56303
Stearns County (320) 255-6393
MORIAH ROSE LELOU
Licensed Practical Nurse
4801 VETERANS DR
SAINT CLOUD, MN 56303
Stearns County (320) 252-1670
SARA BUKOWSKI
Health and Wellness Coach
4801 VETERANS DR
SAINT CLOUD, MN 56303
Stearns County (320) 252-1670
CARRIE ANNE MACIEJ RN
Registered Nurse
4801 VETERANS DR
SAINT CLOUD, MN 56303
Stearns County (320) 252-1670

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 Kolu Moore's NPI number?

The NPI number for Kolu Moore is 1639970072. It was assigned to this individual provider in the NPPES registry on March 21, 2025.

Where is Kolu Moore located?

Kolu Moore practices at 4801 Veterans Dr, Saint Cloud, MN 56303. The listed phone number is (320) 252-1670.

What is Kolu 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 Kolu Moore was last updated on March 21, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.