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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

SUSAN KELLY NIEBAUM, PMHNP-BC

Active Sole Proprietor

SUSAN KELLY NIEBAUM, PMHNP-BC is a Psychiatric/Mental Health Nurse Practitioner healthcare provider located in SOUTH SALT LAKE, Utah. NPI 1861165839 is currently active in the NPPES registry. Verify at CMS.

Psychiatric/Mental Health Nurse Practitioner · SOUTH SALT LAKE, UT

Registration Details

NPI Number
1861165839
Provider Type
Individual
Gender
Female
NPI Issued
Jul 27, 2021 (5.0062118590306 yrs)
Last Updated
Feb 3, 2022
Licenses
12585557-4405 (UT)
16869 (MT)
Sole Proprietor
Yes

Practice Information

Address
408 E KELSEY VIEW LN
SOUTH SALT LAKE, UT, 841154979
Browse UT providers · Browse ZIP 84115
Phone
4062122177

Other Psychiatric/Mental Health Nurse Practitioner Providers in SOUTH SALT LAKE, UT

Name Credential NPI
ARMANDO WAYNE SLACK APRN 1659572949
DANIEL DOBBS HAMMOND JR. MSN, RN, ANP 1518116839
MELISSA RADCLIFFE APNP 1992356240
DANIELLE BENNETT DNP, APRN, PMHNP-BC 1831881903
DR. EMILY ELIZABETH BARROWS DNP 1275212524
MARY DANIELLE KUYKENDALL PMHNP, APRN 1609556596
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.