Individual
KELSEY EILEEN MOE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PCP-NP
Contact information
Practice address
305 E JEFFERSON ST, BOISE, ID 83712-6231
(208) 706-5437
Mailing address
305 E JEFFERSON ST, BOISE, ID 83712-6231
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
202530200
ID
Other
Enumeration date
12/08/2025
Last updated
12/08/2025
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