Individual
SUSAN ALICE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
165 TOR CT, PITTSFIELD, MA 01201-3001
(413) 447-2862
(413) 395-7990
Mailing address
165 TOR CT, PITTSFIELD, MA 01201-3001
(413) 447-2862
(413) 395-7990
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
156578
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MA156578
MASS LICENSE
MA
Enumeration date
04/02/2007
Last updated
01/23/2013
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