Susan Kelly Niebaum, PMHNP-BC
NPI #1861165839 in South Salt Lake, Utah
Provider Information
- NPI Number
- 1861165839
- Entity Type
- Individual
- Name
- Susan Kelly Niebaum, PMHNP-BC
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Nurse Practitioner - Psychiatric/Mental Health
- Credential
- PMHNP-BC
- Enumeration Date
- Jul 27, 2021
- Last Updated
- Feb 3, 2022
Practice Location
- Address
- 408 E KELSEY VIEW LN
- City
- South Salt Lake
- State
- Utah
- ZIP Code
- 84115-4979
- Phone
- (406) 212-2177
Specialties & Taxonomy Codes
| Specialty |
|---|
| Nurse Practitioner - Psychiatric/Mental Health — Psychiatric/Mental Health |
| Registered Nurse - Psychiatric/Mental Health, Child & Adolescent — Psychiatric/Mental Health, Child & Adolescent |
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