Individual
DEREK MOOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
AGPCNP-BC
Contact information
Practice address
2977 WEST, 2600 SOUTH, SYRACUSE, UT 84075
(801) 682-6170
Mailing address
2977 WEST, 2600 SOUTH, SYRACUSE, UT 84075
(801) 682-6170
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
6586693-4405
UT
Other
Enumeration date
08/14/2024
Last updated
08/14/2024
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