Individual
SUSAN C SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANP-BC
Contact information
Practice address
8101 CLEARVISTA PKWY, SUITE 200, INDIANAPOLIS, IN 46256-4696
(317) 621-5390
(317) 621-7885
Mailing address
6626 E. 75TH STREET, SUITE 500, INDIANAPOLIS, IN 46250-2890
(317) 621-4139
(317) 621-7885
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
28093663A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000797592
BCBS
IN
05
—
201117920
—
IN
Enumeration date
12/20/2011
Last updated
11/27/2023
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