Individual
ANN N MOFFETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
858 COMMERCE DR., SMELTERVILLE, ID 83858
(208) 784-4612
Mailing address
25 JACOBS GULCH RD, KELLOGG, ID 83837-2023
(208) 784-4612
(208) 783-1342
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
57731
ID
Other
Enumeration date
02/01/2018
Last updated
02/19/2019
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