Susan L Ralph, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

N-45447 Issued in ID

Practice address

14 S Baltic PL
Suite 106
Meridian, ID 83642-5935

Phone

(208) 887-4872

Fax

(208) 887-6331

NPI assigned

Apr 4, 2012

Last updated

Jan 7, 2015By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other names 1

• Susan Lynette Lords Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1333497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1420588800000",
    "number": "1629334651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4914 ASBURY WAY",
            "city": "CALDWELL",
            "state": "ID",
            "postal_code": "836077908",
            "telephone_number": "208-695-3587"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14 S BALTIC PL",
            "address_2": "SUITE 106",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836425935",
            "telephone_number": "208-887-4872",
            "fax_number": "208-887-6331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RALPH",
        "first_name": "SUSAN",
        "middle_name": "L",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-04",
        "last_updated": "2015-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ID",
            "license": "N-45447",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "TAP4415",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUSAN",
            "last_name": "LORDS",
            "middle_name": "LYNETTE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Family Nurse Practitioner in Meridian, ID
• Providers in Meridian, ID by specialty
• Family Nurse Practitioner in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.