Individual
SUSAN L DUMMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
980 W. IRONWOOD, SUITE 101, COEUR D'ALENE, ID 83814
(208) 765-1455
(208) 667-8655
Mailing address
980 W. IRONWOOD, SUITE 101, COEUR D'ALENE, ID 83814
(208) 765-1455
(208) 667-8655
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
N-19918
ID
363L00000X
Nurse Practitioner
Primary
NP203A
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002791900
—
ID
Enumeration date
06/27/2006
Last updated
07/28/2010
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