Individual
HEATHER A MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1970 E 17TH ST, STE. 207, IDAHO FALLS, ID 83404-8014
(208) 523-5319
(208) 523-5627
Mailing address
PO BOX 2106, IDAHO FALLS, ID 83403-2106
(208) 523-5319
(208) 523-5627
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
N-38418
ID
Other
Enumeration date
10/03/2013
Last updated
10/03/2013
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