Individual
SUSAN L RALPH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
14 S BALTIC PL, SUITE 106, MERIDIAN, ID 83642-5935
(208) 887-4872
(208) 887-6331
Mailing address
4914 ASBURY WAY, CALDWELL, ID 83607-7908
(208) 695-3587
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
N-45447
ID
363LF0000X
Family Nurse Practitioner
TAP4415
AZ
Other
Enumeration date
04/04/2012
Last updated
01/07/2015
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