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1790119238
ILLARIA C MOORE
BOISE, ID
NPI
1790119238
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LA2200X Nurse Practitioner, Adult Health
(Licence: ID NP-1326A)
Enumeration Date
2013-08-31
Last Update Date
2013-08-31
Business Address
-- ILLARIA C MOORE NP-C
11050 MONTANA AVE
BOISE, ID 83713-5049
Phone number: 208-954-6783
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Mailing Address
-- ILLARIA C MOORE NP-C
11050 MONTANA AVE
BOISE, ID 83713-5049
Phone number: 208-954-6783
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