Individual provider · Type 1 NPI

Kelly Moore, NP

Psychiatric/Mental Health Nurse Practitioner · Boise, ID

NPI number 1104303072 Active

Practice location

703 S Americana Blvd Ste 150
Boise, ID 83702-4976

Mailing address

190 E Bannock St
Boise, ID 83712-6241

Other practice locations

  • 3280 E Lanark Dr, Meridian, ID 83642-5982 · (208) 377-4400

Specialties and licenses

TaxonomyCodeLicense
Nurse Practitioner 363L00000X59308 (ID)
Psychiatric/Mental Health Nurse Practitioner Primary 363LP0808X59308 (ID)

Psychiatric/Mental Health Nurse Practitioner: Definition to come...

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About NPI 1104303072

Kelly Moore, NP's National Provider Identifier is 1104303072, issued on Jul 24, 2018. The primary taxonomy on file is Psychiatric/Mental Health Nurse Practitioner (363LP0808X), and the practice location is in Boise, ID. The record was last updated on Mar 21, 2023.