Individual
RETA SUTTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, CDE
Contact information
Practice address
1226 W RIVER ST, BOISE, ID 83702-7049
(208) 331-1155
(208) 383-0190
Mailing address
2719 KNOB HILL RD, MIDVALE, ID 83645-5325
(208) 355-2443
Taxonomy
Speciality
Code
Description
License number
State
163WD0400X
Diabetes Educator Registered Nurse
Primary
N-18844
ID
Other
Enumeration date
03/26/2007
Last updated
07/08/2007
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