Individual
DEENA SURERUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
2265 W BROADWAY ST, IDAHO FALLS, ID 83402-2996
(208) 524-7400
(208) 524-8004
Mailing address
2265 W BROADWAY ST, IDAHO FALLS, ID 83402-2996
(208) 524-7400
(208) 524-8004
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
1722
ID
Other
Enumeration date
11/15/2025
Last updated
11/15/2025
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