Niebaum, Susan Kelly

Niebaum, Susan Kelly is an sole proprietor health care provider with primary practice located at 408 E Kelsey View Ln , South Salt Lake UT 84115-4979. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health, Nursing Service Providers / Psychiatric/Mental Health, Child & Adolescent. Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health is her primary health care specialty. Niebaum, Susan Kelly can be contacted via phone (406) 212-2177.

Contact Information

Primary practice address
408 E Kelsey View Ln South Salt Lake UT 84115-4979
Phone: (406) 212-2177
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X 12585557-4405 Utah
Nursing Service Providers / Psychiatric/Mental Health, Child & Adolescent 163WP0807X 16869 Montana

Profile Details

NPI number 1861165839
LBN Legal business name Niebaum, Susan Kelly
Credentials PMHNP-BC
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 27th, 2021
Last updated Feb 3rd, 2022 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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