MEDICARE: KELSEY MOREY FNP-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	6581203	ID

General Provider Information

NPI Number	:	1699617266
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KELSEY MOREY FNP-C

Provider Business Mailing Address
First Line	:	219 S WOODDALE AVE
Second Line	:
City	:	EAGLE
State	:	ID
Zip	:	83616-7714
Country	:	US
Telephone Number	:	208-994-5575
Fax Number	:

Provider Business Practice Location Address
First Line	:	219 S WOODDALE AVE
Second Line	:
City	:	EAGLE
State	:	ID
Zip	:	83616-7714
Country	:	US
Telephone Number	:	208-994-5575
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/06/2026
Last Update Date	:	04/07/2026

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Directions to “ KELSEY MOREY FNP-C” Practice Location

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