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1205124377
MARISUE SUSMAN
MERIDIAN, ID
NPI
1205124377
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LP0200X Nurse Practitioner, Pediatrics
(Licence: ID NP-1488A)
Enumeration Date
2011-07-11
Last Update Date
2015-10-27
Business Address
-- MARISUE SUSMAN NP
1620 S CELEBRATION AVE
MERIDIAN, ID 83642-2779
Phone number: 208-884-1030
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Mailing Address
-- MARISUE SUSMAN NP
190 E BANNOCK ST
BOISE, ID 83712-6241
Phone number: 208-381-2222
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