Individual
STACY MARIE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
1310 E 7TH ST., STE J, AUBURN, IN 46706
(260) 925-0305
(260) 925-6041
Mailing address
1310 E 7TH ST STE J, AUBURN, IN 46706-2518
(260) 925-0305
(260) 925-6041
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
28131467A
IN
207Q00000X
Family Medicine Physician
Primary
351434141
IN
363LF0000X
Family Nurse Practitioner
71003749A
IN
Other
Enumeration date
09/26/2011
Last updated
12/31/2019
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