| Ms Susan M Derivas, CNP | |
|
4055 E Blueberry St, Meridian, ID 83642-8261 | |
| (208) 775-7418 | |
| (208) 647-5008 |
| Full Name | Ms Susan M Derivas |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner - Psychiatric/mental Health |
| Location | 4055 E Blueberry St, Meridian, Idaho |
| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851493829 | NPI | - | NPPES |
| 13961493 | Other | CAQH PROVIDER ID | |
| 396453 | Other | MASTER BILLING ID (OSMIND) | |
| 208-775-7418 | Other | SPRUCE HEALTH | |
| 932434 | Other | AVAILITY ID | |
| 0062-0104069 | Other | UNITED HEALTHCARE SERVICES, PROVIDER NO. | |
| 1851493829 | Other | CLOZAPINE REMS CERTIFIED | |
| 5708247 | Other | ID | EVERNORTH |
| 1032026 | Medicaid | ID | |
| 909072 | Other | CHANGE HEALTHCARE SUBMITTER ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363LP0808X | Nurse Practitioner - Psychiatric/mental Health | 64266 (Idaho) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Ms Susan M Derivas, CNP 4055 E Blueberry St, Meridian, ID 83642-8261 Ph: (208) 775-7418 | Ms Susan M Derivas, CNP 4055 E Blueberry St, Meridian, ID 83642-8261 Ph: (208) 775-7418 |
Jennifer Lytle, FNP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1526 W Ustick Rd Ste 110, Meridian, ID 83646 Phone: 208-370-5888 |
Rachael Marie Knuteson, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1948 S Eagle Rd, Meridian, ID 83642 Phone: 208-322-7900 |
Heidi Ann Fanslow, PMHNP-BC Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 6830 N Agrarian Ave, Meridian, ID 83646 Phone: 253-951-8331 |
Jessica Rose Johnson, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 3520 E Louise Dr, Meridian, ID 83642 Phone: 208-888-0909 Fax: 208-888-5825 |
Josef Mcguire, NP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 3080 E Gentry Way Ste 210, Meridian, ID 83642 Phone: 208-384-9022 |
Bailey Allison Andreasen, WHNP-BC Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 3520 E Louise Dr, Meridian, ID 83642 Phone: 208-888-0909 |
Michael Pahang, PMHNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1550 N Crestmont Dr, Meridian, ID 83642 Phone: 208-288-4200 Fax: 208-288-4279 |