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Individual

NEIL MOONEY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
RN

Contact information

Practice address
406 BURRELL AVE, LEWISTON, ID 83501-4524
(208) 743-1124
Mailing address
2109 S KERR ST, BOISE, ID 83705-3415

Taxonomy

Speciality
Code
Description
License number
State
163WF0300X
Flight Registered Nurse
Primary
55059
ID

Other

Enumeration date
02/20/2025
Last updated
02/20/2025
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