Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Susan Kelly Niebaum, PMHNP-BC

Individual provider Psychiatric/Mental Health Nurse Practitioner · NPI 1861165839

Susan Kelly Niebaum, PMHNP-BC is a Psychiatric/Mental Health Nurse Practitioner in South Salt Lake, Utah. Practices as a sole proprietor. Licensed in Montana and Utah.

Licensed in
MT, UT
In the registry since
2021
Specialties on file
2
What do these letters mean?
PMHNP-BC — Psychiatric-Mental Health Nurse Practitioner, Board Certified
A board-certified psychiatric nurse practitioner.

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Practice location Address checks out

408 E Kelsey View Ln
South Salt Lake, UT 84115-4979
Phone: (406) 212-2177
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychiatric/Mental Health Nurse Practitioner (primary) Taxonomy 363LP0808X · Licence 12585557-4405 (UT)
Child & Adolescent Psychiatric/Mental Health Registered Nurse Taxonomy 163WP0807X · Licence 16869 (MT)

Record details

NPI number1861165839
Entity typeIndividual (Type 1)
GenderFemale
Credentials PMHNP-BC
Sole proprietorYes
NPI enumeratedJuly 27, 2021
Last updated in NPPESFebruary 3, 2022
Certification dateFebruary 3, 2022

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