ILLARIA C MOORE (NPI# 1790119238) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790119238 |
| Entity Type | Individual |
| Full Name | ILLARIA C MOORE |
| Credential | NP-C |
| Practice Address |
11050 Montana Ave Boise ID 83713-5049 |
| Practice Telephone | 2089546783 |
| Mailing Telephone | 2089546783 |
| Enumeration Date | 2013-08-31 |
| Last Update Date | 2013-08-31 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
NP-1326A | ID | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NURSE PRACTITIONER CERTIFICATION | AG0613029 | 01 | |
| ID | LICENSE NUMBER | NP-1326A | 01 |
| Street Address |
11050 MONTANA AVE |
| City | BOISE |
| State | ID |
| Zip Code | 83713-5049 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265902332 | Kidscare Home Health of Idaho, LLC | Home Health | 1835 Wildwood Street, Boise, ID 83713 | 2018-11-30 |
| 1417463928 | Kimberly Ann Bohrer | Behavioral Analyst | 12053 W Hickory Dr, Boise, ID 83713 | 2017-12-19 |
| 1407371891 | Emir Hadzic | Optometrist | 13239 W. Fernleaf St., Boise, ID 83713 | 2017-08-07 |
| 1518336650 | Alliance Physical Medicine | Nurse Practitioner | 13909 W Wainwright Drive, Boise, ID 83713 | 2015-09-18 |
| 1083038335 | Jan L Rehder | Nurse Practitioner | 13150 W Persimmon Lane, Boise, ID 83713 | 2014-02-06 |
| 1508287061 | Heather N Fox | Physician Assistant | 12273 West Mcmillan Road, Boise, ID 83713 | 2013-12-30 |
| 1659667459 | Jayson Clark | Dentist | 4274 N Eagle Road, Boise, ID 83713 | 2011-06-21 |
| 1043503659 | Steven Anthony Eckhoff | Physician Assistant | 11662 W Arlen St, Boise, ID 83713 | 2011-05-16 |
| 1790923621 | Christie Dudash Flynn | Physician Assistant | 12273 W Mcmillian Road, Boise, ID 83713 | 2009-01-30 |
| 1699930404 | Dennis J. Garpetti, Dds, P.C. | Dentist | 13108 West Persimmon Lane, Boise, ID 83713 | 2008-07-21 |
| Find all providers in zip 83713 | ||||
| Taxonomy Code | 363LA2200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Adult Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881017382 | Joniruth Digaum | Nurse Practitioner | 8040 S Red Cliff Ave, Boise, ID 83716-3466 | 2014-02-04 |
| 1851438006 | Gregory C Galloway | Nurse Practitioner | 5440 W Franklin Rd, Suite 100, Boise, ID 83705-1079 | 2007-01-30 |
| 1154436426 | Amy Hoffmann | Nurse Practitioner | 3210 N Mountain View Dr, Boise, ID 83704-4635 | 2006-08-20 |
| 1598774275 | Barbara L Irish | Nurse Practitioner | 1000 N Curtis Road, Suite 305, Boise, ID 83706 | 2006-08-05 |
| 1225020993 | April D Southwick | Nurse Practitioner | 703 S Americana Blvd, Ste 130, Boise, ID 83702-5099 | 2005-08-18 |
| 1316558596 | Jonathan Adar Shectman | Nurse Practitioner | 500 W Fort St, Boise, ID 83702-4501 | 2020-08-12 |
| 1336762566 | Treasure Valley Healthcare Pllc | Nurse Practitioner | 5108 N Maidstone Way, Boise, ID 83713-1367 | 2020-05-21 |
| 1902459266 | Melissa Adele Wren Perry | Nurse Practitioner | 300 S 23rd St, Boise, ID 83702-9100 | 2019-07-16 |
| 1144702796 | Michelle Ann Mcneley | Nurse Practitioner | 500 W Fort St, Boise, ID 83702-4599 | 2018-08-30 |
| 1912416413 | Heather Ann Stafford | Nurse Practitioner | 500 W Fort St, Boise, ID 83702-4501 | 2017-09-27 |
| Find all providers in BOISE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.