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Individual

SUZANNE MARIE SMITH

Active
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Individual

SUZANNE MARIE SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MSN, RN, CNS, FNP

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
28156702A
IN
363LF0000X
Family Nurse Practitioner
Primary
71003293A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200996360
—
IN
01
—
M400023960
MEDICARE PTAN
IN
01
—
MI4120001
MEDICARE PTAN
MI
Enumeration date
07/01/2010
Last updated
09/20/2023
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