Moughamian, Jill
Moughamian, Jill is an individual health care provider with primary practice located at 4700 N Cloverdale Rd Ste 103 , Boise ID 83713-1067. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Pediatrics, which is considered as her primary health care specialty. Moughamian, Jill can be contacted via phone (208) 392-8383.Contact Information
Primary practice address
4700 N Cloverdale Rd Ste 103
Boise ID 83713-1067
Phone: (208) 392-8383
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Pediatrics | 363LP0200X | NP-1708A | Idaho |
Profile Details
| NPI number | 1760845259 |
|---|---|
| LBN Legal business name | Moughamian, Jill |
| Credentials | Nurse Practitioner (NP) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 1st, 2016 |
| Last updated | Apr 1st, 2016 - about 9 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1760845259 | NPPES |
| Idaho | Other | NP-1708A | STATE LICENSE |
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