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Individual
JEANNE BETZ SMOOT
Active
Individual
JEANNE BETZ SMOOT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Taxonomy
Speciality
Code
Description
License number
State
208VP0000X
Pain Medicine Physician
Primary
R112789
MD
363LG0600X
Gerontology Nurse Practitioner
R112789
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
613335-01
BLUE CROSS/BLUE SHIELD
MD
05
—
699065700
—
MD
Enumeration date
06/11/2006
Last updated
04/17/2019
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