Individual
MRS. EMILY THERESA MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
707 N ARMSTRONG PL, BOISE, ID 83704-0825
(208) 327-7400
(208) 327-8579
Mailing address
7096 BIG FOOT RD, MELBA, ID 83641-5074
(208) 495-1500
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
NP112A
ID
Other
Enumeration date
03/08/2007
Last updated
07/08/2007
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