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Brandi Lee Moss
General Practice Registered Nurse in Malad City, Idaho
NPI 1922725746

Brandi Lee Moss is a General Practice Registered Nurse based in Malad City, ID and is specialized in General Practice. Brandi Lee Moss practices in Malad City, ID. The NPI Number for Brandi Lee Moss is 1922725746 and holds a License No. 73108 (Idaho).

The current practice location address for Brandi Lee Moss is 975 S 2100 W, Malad City, ID and can be reached out via phone at 801-358-9683.

Location: 975 S 2100 W, Malad City, ID, 83252-4925
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1922725746
Provider Name
Brandi Lee Moss
Credential
Provider Entity Type
Individual
Gender
Female
Address
975 S 2100 W, Malad City, ID, 83252-4925
Phone Number
801-358-9683
Fax Number
Provider Enumeration Date
10/24/2022
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
975 S 2100 W
City
Malad City
State
Idaho
Zip
83252-4925
Phone Number
801-358-9683
Fax Number
person
Provider Business Mailing Address Details
Address
975 S 2100 W
City
Malad City
State
Idaho
Zip
83252-4925
Phone Number
801-358-9683
Fax Number
person
Provider's Taxonomy Details 1
Type
Nursing Service Providers
Classification
Registered Nurse
Speciality
General Practice
Taxonomy
163WG0000X
License No.
73108 (Idaho)
Definition
Definition to come...
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