MS. MARY SUSAN ROACH


Address: 703 N. 1st Street, Mccall, ID 83638-3851
Phone: 2086308002

MS. MARY SUSAN ROACH (NPI# 1437281375) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1437281375
Entity Type Individual
Full Name MS. MARY SUSAN ROACH
Credential FNP
Practice Address 703 N. 1st Street
Mccall
ID 83638-3851
Mailing Address Po Box 470
Mccall
ID 83638-0470
Practice Telephone 2086308002
Practice Fax Number 2086342174
Mailing Telephone 2086342174
Enumeration Date 2007-03-09
Last Update Date 2007-07-08
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363LF0000X Nurse Practitioner
Specialization: Family
NP 87-A ID Physician Assistants & Advanced Practice Nursing Providers

Other Providers MARY ROACH

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1417465311 Mary Antoinettee Roach Pharmacist 12001 Autumnwood Ln, Fort Washington, MD 20744-6065 2018-01-14
1558378521 Mary Roach Nurse Practitioner 2211 Lomas Blvd, Ne, Unm Hospitals, Albuquerque, NM 87106 2006-08-02
1447723978 Mary Theresa Roach Behavior Technician 5 Revere Dr Ste 120, Northbrook, IL 60062-8005 2019-01-08
1053801779 Mary Kathleen Roach Nurse Practitioner 200 E Chestnut St, Louisville, KY 40202-1831 2018-05-17

Office Location

Street Address 703 N. 1ST STREET
City MCCALL
State ID
Zip Code 83638-3851

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1255897708 Seanne Jo Safaii Dietitian, Registered 1100 Heaven's Gate Ct. #1910, Mccall, ID 83638 2019-02-20
1053881284 Debra Ann Jones Yensen Counselor 1242 Herrick Street N, Mccall, ID 83638 2018-11-30
1306369681 Cheyene Joseph Nickerson Pharmacist 132 East Lake Street, Mccall, ID 83638 2017-07-19
1669923892 Amy Leigh Forkan Massage Therapist 301 E Park St., Mccall, ID 83638 2016-10-24
1770982597 Rachel L Smith Acupuncturist 106 E. Park St, Suite 102, Mc Call, ID 83638 2014-08-18
1275944498 Central Idaho Counseling, Pllc Social Worker 125 Commerce St., Suite B, Mccall, ID 83638 2014-05-09
1548690829 Sze Wan Chan Pharmacist 1001 North 2nd Street, Mccall, ID 83638 2013-11-22
1467882274 Tamara Nagoda Speech-Language Pathologist 304 Edgewater Circle, Mccall, ID 83638 2013-11-14
1457537896 Thomas L Moore Counselor 310 E. Lake St., Tom Moore, Mccall, ID 83638 2008-01-16
1659581585 Barbara Gail Norton Social Worker 125 Commerce St, Suite B, Mccall, ID 83638 2007-05-22
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Taxonomy Information

Taxonomy Code 363LF0000X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Family

Taxonomy Definition

Definition to come...

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NPI Name Taxonomy Address Enumeration
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1023617347 Kristina Oliver Nurse Practitioner 980 W Ironwood Dr Ste 302, Coeur D Alene, ID 83814-2668 2020-10-19
1730787482 John Dustin Pena Nurse Practitioner 102 Courthouse Dr Ste F, Salmon, ID 83467-3905 2020-10-14
1982202743 Jayson Paul Smith Nurse Practitioner 1545 East Leighfield Dr., Meridian, ID 83646 2020-10-14
1659979516 Jennifer Anne Gardner Nurse Practitioner 1385 Park View Dr Ste 101, Twin Falls, ID 83301-4390 2020-10-13
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1013522275 Beau Lee Nurse Practitioner 2900 N Burton St, Boise, ID 83704-5314 2020-09-14
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Competitor

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City MCCALL
Zip Code 83638

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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