Individual provider · Type 1 NPI
Derek Moos, AGPCNP-BC
Primary Care Nurse Practitioner · Syracuse, UT
NPI number
1104658749
Active
Practice location
2977 West, 2600 South
Syracuse, UT 84075
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Primary Care Nurse Practitioner Primary | 363LP2300X | 6586693-4405 (UT) |
Primary Care Nurse Practitioner: Definition to come...
About NPI 1104658749
Derek Moos, AGPCNP-BC's National Provider Identifier is 1104658749, issued on Aug 14, 2024. The primary taxonomy on file is Primary Care Nurse Practitioner (363LP2300X), and the practice location is in Syracuse, UT. The record was last updated on Aug 14, 2024.