IndividualActive
Derek Moos, AGPCNP-BC
NPI 1104658749 · Primary Care Nurse Practitioner · Syracuse, UT
Provider details
- NPI number
- 1104658749
- Entity type
- Individual
- Primary specialty
- Primary Care Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- AGPCNP-BC
- Sex
- Male
- Sole proprietor
- Yes
- License
- 6586693-4405 (UT)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Practice location
2977 West
2600 South
Syracuse, UT 84075
Phone: (801) 682-6170
Approximate (ZIP-level) locationGet directions
Mailing address
2977 West
Syracuse, UT 84075
Registry dates
- Enumerated
- 2024-08-14
- Last updated
- 2024-08-14
- Certified
- 2024-08-11
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.