Individual provider · Type 1 NPI

Marisue Susman, NP

Pediatric Nurse Practitioner · Meridian, ID

NPI number 1205124377 Active

Practice location

1620 S Celebration Ave
Meridian, ID 83642-2779

Fax (208) 884-3058

Mailing address

190 E Bannock St
Boise, ID 83712-6241

Specialties and licenses

TaxonomyCodeLicense
Pediatric Nurse Practitioner Primary 363LP0200XNP-1488A (ID)

Pediatric Nurse Practitioner: Definition to come...

13 other providers at this address

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About NPI 1205124377

Marisue Susman, NP's National Provider Identifier is 1205124377, issued on Jul 11, 2011. The primary taxonomy on file is Pediatric Nurse Practitioner (363LP0200X), and the practice location is in Meridian, ID. The record was last updated on Oct 27, 2015.