Individual
JULIE MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
207 1ST ST S, NAMPA, ID 83651-3703
(208) 466-7869
(208) 466-0009
Mailing address
PO BOX 9, NAMPA, ID 83653-0009
(208) 461-7149
(208) 467-3391
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
770383
CA
363L00000X
Nurse Practitioner
Primary
69699
ID
363LF0000X
Family Nurse Practitioner
95012549
CA
Other
Enumeration date
02/21/2019
Last updated
05/14/2026
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