Provider Demographics
NPI:1831990100
Name:MORAN, SEKOYA RAE (PHARMD)
Entity type:Individual
Prefix:
First Name:SEKOYA
Middle Name:RAE
Last Name:MORAN
Suffix:
Gender:
Credentials:PHARMD
Other - Prefix:
Other - First Name:SEKOYA
Other - Middle Name:RAE
Other - Last Name:ROMERO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5 SAGE RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:LARAMIE
Mailing Address - State:WY
Mailing Address - Zip Code:82072-9522
Mailing Address - Country:US
Mailing Address - Phone:307-761-2688
Mailing Address - Fax:
Practice Address - Street 1:500 W FORT ST
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83702-4501
Practice Address - Country:US
Practice Address - Phone:208-422-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-22
Last Update Date:2025-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program