Individual
MS. SHEILA MOSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
740 S WOODRUFF AVE, IDAHO FALLS, ID 83401-5285
(208) 542-9111
(208) 542-9114
Mailing address
740 S WOODRUFF AVE, IDAHO FALLS, ID 83401-5285
(208) 542-9111
(208) 542-9114
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
200850072NP
OR
363L00000X
Nurse Practitioner
NP-868A
ID
363LF0000X
Family Nurse Practitioner
Primary
NP-868A
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1538322060
—
ID
01
—
NP868A
STATE
ID
Enumeration date
07/03/2008
Last updated
12/29/2020
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