Individual
MS. LISA JUNE MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
SIMPLY YOU HEALTH & MEDSPA, 219 S. WOODDALE AVE., EAGLE, ID 83616
(208) 994-5576
(208) 529-6428
Mailing address
163 W. FLOATING FEATHER RD, EAGLE, ID 83616
(208) 419-6499
(208) 529-6428
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
NP 669-A
ID
363LF0000X
Family Nurse Practitioner
Primary
NP 669-A
ID
Other
Enumeration date
04/19/2007
Last updated
11/21/2023
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