P Praxis·MD
● Active Type 1 · Individual

Illaria C Moore, NP-C

Nurse Practitioner·Boise, ID· NPI 1790119238 · Enumerated 2013 · 12 years on NPI
Moore is 1 of 24 nurse practitioner providers in Boise and 1 of 56 in Idaho.
NPI age
12 years
Enumerated 2013-08-31
Primary specialty
Nurse Practitioner
Licensed in
ID
1 state
Status
Active
No deactivations on record
Last NPPES update
2013-08-31
Source: monthly bulk 2026-05
Sole proprietor
No
May be part of a larger org

How this provider compares

Across 56 active nurse practitioner providers in Idaho.

NPI age
12 years
≈ at median (13 yr)
State licenses
1 state
35% of peers hold multiple states
Subspecialties
0
66% of peers hold subspecialties

NPI lifetime · 2013 → 2026

2013-08Enumerated in NPPES
2013 2026

Where they practice

Practice location
11050 Montana Ave
Boise, ID 837135049
📞 2089546783
Mailing address
11050 Montana Ave
Boise, ID 837135049
📞 2089546783

Specialties

  • Nurse Practitioner Primary
    Definition to come...
    ID license #NP-1326A taxonomy 363LA2200X

Identifiers

TypeValueNotes
01 AG0613029 NURSE PRACTITIONER CERTIFICATION
01 (ID) NP-1326A LICENSE NUMBER

Practice context

Solo or small practice. No other active providers share this practice address in NPPES.

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How to verify this provider

  1. Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
  2. Check the state license is currently active.State licensing boards publish current status; NPPES does not.
  3. Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.

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