MARISUE SUSMAN (NPI# 1205124377) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205124377 |
| Entity Type | Individual |
| Full Name | MARISUE SUSMAN |
| Credential | NP |
| Practice Address |
1620 S Celebration Ave Meridian ID 83642-2779 |
| Mailing Address |
190 E Bannock St Boise ID 83712-6241 |
| Practice Telephone | 2088841030 |
| Practice Fax Number | 2088843058 |
| Mailing Telephone | 2083812222 |
| Enumeration Date | 2011-07-11 |
| Last Update Date | 2015-10-27 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
NP-1488A | ID | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1620 S CELEBRATION AVE |
| City | MERIDIAN |
| State | ID |
| Zip Code | 83642-2779 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477501880 | Elsa J. Lee | Pediatrics | 1620 S Celebration Ave, Meridian, ID 83642-2779 | 2006-05-05 |
| 1437576584 | Andrea Elisabeth Prasch | Pediatrics | 1620 S Celebration Ave, Meridian, ID 83642-2779 | 2014-03-26 |
| 1588943435 | Shauna L Ellefson | Nurse Practitioner | 1620 S Celebration Ave, Ste 400, Meridian, ID 83642-2779 | 2011-08-10 |
| 1164738134 | Treasure Valley Service Coordination | Pediatrics | 1620 S Celebration Ave, Meridian, ID 83642-2779 | 2010-08-27 |
| 1750599049 | Khristine L. Miller | Pediatrics | 1620 S Celebration Ave, Meridian, ID 83642-2779 | 2007-05-18 |
| 1881812154 | Eric D. Roy | Pediatrics | 1620 S Celebration Ave, Meridian, ID 83642-2779 | 2007-04-23 |
| 1396824512 | Treasure Valley Pediatrics | Pediatrics | 1620 S Celebration Ave, Meridian, ID 83642-2779 | 2006-11-06 |
| 1184636375 | Lisa M. Barker | Pediatrics | 1620 S Celebration Ave, Meridian, ID 83642-2779 | 2006-08-13 |
| 1396794665 | John W. Hanks | Pediatrics | 1620 S Celebration Ave, Meridian, ID 83642-2779 | 2006-05-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174145684 | Ikdo South Meridian LLC | Dentist | 3839 E Amity Rd, Meridian, ID 83642 | 2020-05-07 |
| 1073133328 | Prescription Pad LLC | Pharmacy | 885 S Vanguard Way, Meridian, ID 83642 | 2020-04-16 |
| 1609412683 | Meridian Advanced Psychiatry, LLC | Psychiatry & Neurology | 1672 S Woodsage Ave., Meridan, ID 83642 | 2019-11-25 |
| 1194378927 | Sergey Tsema | Occupational Therapist | 1259 E Pisa St, Meridian, ID 83642 | 2019-07-21 |
| 1003478629 | Chris R Jackson | Dentist | Isu Family Dentistry, 1311 E Central Dr, Meridian, ID 83642 | 2019-07-03 |
| 1285293118 | Morgan Family Medicine | Nurse Practitioner | 1660 S Woodsage Avenue, Meridian, ID 83642 | 2019-06-13 |
| 1033772793 | Nugen Healthcare, Pllc | Registered Nurse | 2177 S Spoonbill Ave, Meridian, ID 83642 | 2019-04-18 |
| 1811471790 | Courtney Crossland | Physician Assistant | 4949 S Hillsdale Ave., Meridian, ID 83642 | 2018-09-18 |
| 1841771938 | Katelyn Perry | Counselor | 2068 S. Eagle Rd., Meridian, ID 83642 | 2018-08-27 |
| 1114406204 | Gem Prep: Meridian LLC | Case Management | 2750 E.gala Ct., Meridian, ID 83642 | 2018-08-09 |
| Find all providers in zip 83642 | ||||
| Taxonomy Code | 363LP0200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Pediatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376700799 | Monica Hermine Mccullough | Nurse Practitioner | 3525 E Louise Dr Ste 250, Meridian, ID 83642-6303 | 2008-05-22 |
| 1164411864 | Nancy Norine Miller | Nurse Practitioner | 925 W 1st St, Meridian, ID 83642 | 2005-10-17 |
| 1841770674 | Olivia Holmes | Nurse Practitioner | 3280 E. Lanark Drive, Meridian, ID 83642 | 2018-08-21 |
| 1942713771 | Kristen Larkin | Nurse Practitioner | 3280 E. Lanark Drive, Meridian, ID 83642 | 2017-11-15 |
| 1427282599 | Toni T. Harris | Nurse Practitioner | 1523 22nd Ave Ste B, Meridian, MS 39301 | 2009-05-05 |
| 1801008305 | Vanessa Irene Mccrory | Nurse Practitioner | 3653 N. Locust Grove Road, Meridian, ID 83646 | 2007-05-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356959100 | Taylor Frances Mello | Nurse Practitioner | 2770 N Woodview Pl, Boise, ID 83702-6541 | 2020-07-17 |
| 1275192205 | Luna Hodges | Nurse Practitioner | 125 E Idaho St Ste 200, Boise, ID 83712-6225 | 2019-06-12 |
| 1740750710 | Nurture Lactation Support for Women & Infants | Nurse Practitioner | 5480 Gleneagles Dr, Idaho Falls, ID 83401-6315 | 2018-12-03 |
| 1790291276 | Bee Happy Pediatrics | Nurse Practitioner | 3412 South 25th East, Idaho Falls, ID 83406-4967 | 2017-12-20 |
| 1568679603 | Kathleen Bridget Marshall | Nurse Practitioner | 717 Mission Rd., Fort Hall, ID 83203-0717 | 2007-05-17 |
| 1073675617 | Leona Jo'anne' Church | Nurse Practitioner | 1655 W Fairview Ave Ste 206, Boise, ID 83702-5190 | 2006-12-13 |
| 1861477838 | Margaret Anne Fry Lawson | Nurse Practitioner | 637 E Deer Flat Rd, Kuna, ID 83634-3444 | 2005-12-13 |
| 1033102579 | Karen L Godard | Nurse Practitioner | 1305 3rd St S, Nampa, ID 83651-3903 | 2005-08-30 |
| 1386204758 | Aimee Lynn Hastriter | Nurse Practitioner | 125 E Idaho St Ste 200, Boise, ID 83712-6225 | 2019-06-18 |
| 1659844066 | Rachel Bentley | Nurse Practitioner | 1072 N Liberty St Ste 200, Boise, ID 83704-8963 | 2019-01-08 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.