SUSAN M DERIVAS

MERIDIAN, ID
NPI1851493829
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy363LP0808X Nurse Practitioner, Psych/Mental Health
(Licence: ID  64266)
Enumeration Date2006-09-01
Last Update Date2024-02-07
Business Address
Ms. SUSAN M DERIVAS CNP
4055 E BLUEBERRY ST
MERIDIAN, ID 83642-8261
Phone number: 208-775-7418
Mailing Address
Ms. SUSAN M DERIVAS CNP
4055 E BLUEBERRY ST
MERIDIAN, ID 83642-8261
Phone number: 208-775-7418
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