Individual
CARLA MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2724 PEBBLE WAY, NAMPA, ID 83686-7978
(208) 571-8710
Mailing address
2724 PEBBLE WAY, NAMPA, ID 83686-7978
(208) 571-8710
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
BB234643E
ID
Other
Enumeration date
06/09/2022
Last updated
06/09/2022
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