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General NPI Number Information
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NPI Number | 1598086522
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Entity Type | Individual
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Provider Name | SUSAN D MCEWEN FNP
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Gender | Female
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Dates
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Enumeration Date | 06/14/2010
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Last Update Date | 02/08/2025
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Provider Practice Location Address
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Address Line | 715 S MAIN ST
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City | KALISPELL
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State | MT
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Zip | 59901-5358
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Country | US
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Telephone | 406-606-6160
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Fax | 406-890-6645
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Provider Business Mailing Address
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Address Line | 411 ORCHARD RIDGE RD
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City | KALISPELL
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State | MT
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Zip | 59901-7565
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Country | US
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Telephone | 406-606-6160
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Fax | 406-890-6645
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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 | 20633
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License Number State | MT
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