| Doctor Name: | SUSAN MARIE WARNER |
| NPI Number: | 1942359898 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RN |
| License Number: | NP 848 |
| Business Practice Address: | 205 N Berkley Council, ID - 83612 |
| Business Phone Number: | 2082534242 |
| Business Fax Number: | 2082536849 |
| Mailing Address: | Po Box 428, COUNCIL |
| State: | ID |
| Postal Code: | 836120428 |
| Phone Number: | 2082534242 |
| Fax Number: | 2082536849 |
| NPI Enumeration Date: | 01/09/2007 |
| NPI Last Update Date: | 12/13/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | NP 848 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | ID |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |