Wilbrecht, Suzanne Moore
Wilbrecht, Suzanne Moore is an individual health care provider with primary practice located at 37 S 2Nd E Ste 200 , Rexburg ID 83440-1906. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Obstetrics & Gynecology, Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife. Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife is her primary health care specialty. Wilbrecht, Suzanne Moore can be contacted via phone (208) 356-0234.Contact Information
Primary practice address
37 S 2Nd E Ste 200
Rexburg ID 83440-1906
Phone: (208) 356-0234
Fax: (208) 656-8877
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Obstetrics & Gynecology | 363LX0001X | RN61139099 | Washington |
| Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife | 367A00000X | 66117 | Idaho |
| Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife | 367A00000X | N361143735 | Washington |
| Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife | 367A00000X | AP61139097 | Washington |
Profile Details
| NPI number | 1861090219 |
|---|---|
| LBN Legal business name | Wilbrecht, Suzanne Moore |
| Credentials | Certified Nurse Midwife (CNM) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 16th, 2020 |
| Last updated | Oct 24th, 2021 - about 3 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1861090219 | NPPES |
| Idaho | Other | 66117 | IDAHO STATE BOARD OF NURSING |
| Idaho | MEDICAID | 2174476 | IDAHO STATE BOARD OF NURSING |
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