Individual
SUSAN ADAMS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN/NDPP COACH
Contact information
Practice address
205 N BERKLEY ST, COUNCIL, ID 83612-5015
(208) 253-4242
(208) 253-6849
Mailing address
PO BOX 428, COUNCIL, ID 83612-0428
(208) 253-4242
(208) 253-6849
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
59284
ID
Other
Enumeration date
05/22/2023
Last updated
05/22/2023
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