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General NPI Number Information
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NPI Number | 1679567465
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Entity Type | Individual
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Provider Name | SUSAN E HERBST PN MS AOCN
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Gender | Female
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Dates
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Enumeration Date | 09/07/2005
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Last Update Date | 02/26/2010
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Provider Practice Location Address
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Address Line | 2000 KOOTENAI HEALTH WAY
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City | COEUR D ALENE
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State | ID
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Zip | 83814
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Country | US
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Telephone | 208-666-2000
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Fax | 208-666-3963
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Provider Business Mailing Address
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Address Line | 2000 KOOTENAI HEALTH WAY
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City | COEUR D ALENE
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State | ID
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Zip | 83814
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Country | US
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Telephone | 208-666-2000
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Fax | 208-666-3963
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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 | 364SX0200X
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Taxonomy Name | Oncology Clinical Nurse Specialist
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License Number | CNS-10A
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License Number State | ID
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