MS. SUSAN LYNN BUNNELL MD NPI 1346216975

NPI Information

NPI: 1346216975
Provider Name: MS. SUSAN LYNN BUNNELL, MD
Classification: Psychiatry & Neurology - 2084P0804X
Entity Type: Individual

Specialization: Child & Adolescent Psychiatry

Address:
2280 E 25TH STREET
IDAHO FALLS, ID
ZIP 83404
Phone: (208) 227-2295
Get Directions

MS. Susan Lynn Bunnell, MD is a child and adolescent psychiatry psychiatry neurology in Idaho Falls, ID. The provider is child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence. MS. Susan Lynn Bunnell, MD NPI is 1346216975. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

2280 E 25TH STREET
IDAHO FALLS, ID
ZIP 83404
Phone: (208) 227-2295
Fax: (208) 227-2364

The enumeration date for this NPI number is 2/24/2006 and was last updated on 12/16/2011.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	2084P0804X	Psychiatry & Neurology	Child & Adolescent Psychiatry	5576	SOUTH DAKOTA	No
2	2084P0804X	Psychiatry & Neurology	Child & Adolescent Psychiatry	M11154	IDAHO	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	7101880	MEDICAID	SOUTH DAKOTA
2	13426216975	MEDICAID	IDAHO
3	D24169	MEDICARE UPIN
4	510539072	MEDICARE ID-TYPE UNSPECIFIED
5	4994379	OTHER	SOUTH DAKOTA	BCBS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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