LYDIA MARIE MOOR

BOISE, ID
NPI1588256846
Former NameLYDIA MARIE THATCHER
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy363LA2100X Nurse Practitioner, Acute Care
(Licence: ID  66852)
Additional Taxonomies363LA2100X Nurse Practitioner, Acute Care
(Licence: AZ  250264)
Enumeration Date2021-02-08
Last Update Date2023-10-23
Business Address
Dr. LYDIA MARIE MOOR CNP
300 E JEFFERSON ST STE 101
BOISE, ID 83712-6221
Phone number: 208-322-1680
Mailing Address
Dr. LYDIA MARIE MOOR CNP
190 E BANNOCK ST
BOISE, ID 83712-6241
Phone number: