| Doctor Name: | SUSAN CAROL NOKLEBY |
| NPI Number: | 1063565281 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RN, MS, LSN |
| License Number: | R 075546-5 |
| Business Practice Address: | 3300 Gillett Dr Nw Bemidji, MN - 566015668 |
| Business Phone Number: | 2183333100 |
| Business Fax Number: | 2183333175 |
| Mailing Address: | 912 Donald Ave Se, BEMIDJI |
| State: | MN |
| Postal Code: | 566014904 |
| Phone Number: | 2187513353 |
| Fax Number: | 2183333175 |
| NPI Enumeration Date: | 01/19/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WS0200X |
| License Number: | R 075546-5 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MN |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | School |
| Taxonomy Definition: | |