Individual
NICOLETTE MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN, FNP-BC
Contact information
Practice address
1770 E FORT UNION BLVD STE 101, SALT LAKE CITY, UT 84121-2881
(801) 997-8881
Mailing address
2387 N 3130 W, LEHI, UT 84043-7308
(801) 854-3854
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
7487553-4405
UT
Other
Enumeration date
01/04/2022
Last updated
01/04/2022
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