Individual
CHARLENE SURBAUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.N., F.A.
Contact information
Practice address
562 SHOUP AVE W, TWIN FALLS, ID 83301-5029
(208) 734-3455
(208) 733-7389
Mailing address
PO BOX 1808, TWIN FALLS, ID 83303-1808
(208) 734-3455
(208) 733-7389
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
N14523
ID
Other
Enumeration date
01/17/2007
Last updated
07/08/2007
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