Doctor Name: | SUSAN P STUTZMAN |
NPI Number: | 1013936541 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | NP |
License Number: | NP198A |
Business Practice Address: | 215 10th St Lewiston, ID - 835011912 |
Business Phone Number: | 2087993100 |
Business Fax Number: | 2087990349 |
Mailing Address: | 215 10th St, LEWISTON |
State: | ID |
Postal Code: | 835011912 |
Phone Number: | 2087993100 |
Fax Number: | 2087990349 |
NPI Enumeration Date: | 07/18/2006 |
NPI Last Update Date: | 07/09/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LW0102X |
License Number: | NP198A |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | ID |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Women's Health |
Taxonomy Definition: |