Individual
SUZANNE NEBEKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
805 MAIN ST, SALMON, ID 83467-0000
(208) 756-6212
(208) 756-6336
Mailing address
203 S DAISY ST, SALMON, ID 83467-0000
(208) 756-5600
(208) 756-4169
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
NP-468A
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
805971500
—
ID
Enumeration date
10/12/2006
Last updated
09/12/2011
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