Individual
MRS. JULIE RAYE MOODY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP
Contact information
Practice address
393 E 2ND N, REXBURG, ID 83440-1605
(208) 359-4840
(208) 359-9010
Mailing address
393 E 2ND N, REXBURG, ID 83440-1605
(208) 359-4840
(208) 359-9010
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
69140
ID
Other
Enumeration date
08/03/2021
Last updated
05/20/2024
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