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General NPI Number Information
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NPI Number | 1023184967
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Entity Type | Individual
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Provider Name | SUSAN CROSS NP
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Gender | Female
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Dates
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Enumeration Date | 11/24/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | HOSPICE OF NORTH IDAHO 9493 N GOVERNMENT WAY
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City | HAYDEN
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State | ID
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Zip | 83835
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Country | US
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Telephone | 208-772-7994
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Fax |
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Provider Business Mailing Address
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Address Line | 255 S THERESA TERRACE DRIVE
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City | POST FALLS
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State | ID
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Zip | 83854
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Country | US
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Telephone | 208-773-0430
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | NP371A
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License Number State | ID
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