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1538611397
SUSAN SANSOM
MERIDIAN, ID
NPI
1538611397
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363L00000X Nurse Practitioner
(Licence: ID 54528)
Enumeration Date
2016-10-27
Last Update Date
2016-10-27
Business Address
SUSAN SANSOM CNP
360 E MONTVUE DR STE 100
MERIDIAN, ID 83642-6318
Phone number: 208-855-2900
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Mailing Address
SUSAN SANSOM CNP
360 E MONTVUE DR STE 100
MERIDIAN, ID 83642-6318
Phone number: 208-855-2900
Copy
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