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Individual

MR. VINCENT ROSS SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DNP, ANP-C

Contact information

Practice address
311 E 89TH AVE, MERRILLVILLE, IN 46410-8162
(219) 769-7062
(630) 495-1770
Mailing address
820 SPRINGER DR, LOMBARD, IL 60148-6413
(708) 634-4602

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN 805484
CA
163W00000X
Registered Nurse
RN80537
NV
163W00000X
Registered Nurse
RN9310400
FL
363LA2200X
Adult Health Nurse Practitioner
28250476A
IN
363LA2200X
Adult Health Nurse Practitioner
Primary
71008935A
IN
363LA2200X
Adult Health Nurse Practitioner
APRN001802
NV
363LA2200X
Adult Health Nurse Practitioner
NP 22695
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
MCO300042636
IN
Enumeration date
08/30/2012
Last updated
04/06/2023
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