Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Lydia Marie Moor, CNP

Individual provider Acute Care Nurse Practitioner · NPI 1588256846

Dr. Lydia Marie Moor, CNP is a Nurse Practitioner in Boise, Idaho. Qualified in 2020, 6 years ago. Practices with St Lukes Clinic-Treasure Valley LLC, a 1,150-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Arizona and Idaho.

Years since qualifying
6
Licensed in
AZ, ID
In the registry since
2021
Specialties on file
2
What do these letters mean?
CNP — Certified Nurse Practitioner
A certified nurse practitioner.

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Practice location Address checks out

300 E Jefferson St Ste 101
Boise, ID 83712-6221
Phone: (208) 322-1680
Fax: (208) 322-1695
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 2220 E 25th St, Idaho Falls, ID 83404-7542 — (520) 343-3647

Specialties & licences

Acute Care Nurse Practitioner (primary) Taxonomy 363LA2100X · Licence 66852 (ID)
Acute Care Nurse Practitioner Taxonomy 363LA2100X · Licence 250264 (AZ)

Record details

NPI number1588256846
Entity typeIndividual (Type 1)
GenderFemale
Credentials CNP
Sole proprietorYes
NPI enumeratedFebruary 8, 2021
Last updated in NPPESOctober 23, 2023
Certification dateOctober 23, 2023

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice St Lukes Clinic-Treasure Valley Llc — 1150 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations6 on file with Medicare

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