Individual
DEBRA JO BAUER SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
14 HAWTHORNE PARK CT, GREENVILLE, SC 29615-3194
(864) 331-0364
(864) 331-0370
Mailing address
212 BUTLER AVE, GREENVILLE, SC 29601-1913
(256) 426-1622
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
1-025651
AL
367500000X
Certified Registered Nurse Anesthetist
Primary
20039
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
51526491
BCBS #
AL
Enumeration date
07/17/2006
Last updated
02/27/2019
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