Individual
MRS. SUSAN R SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1420 E 7TH ST, CHARLOTTE, NC 28204-2408
(704) 375-0100
(704) 887-6450
Mailing address
1420 E 7TH ST, CHARLOTTE, NC 28204-2408
(704) 375-0100
(704) 887-6450
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
79105
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00210985
RR MEDICARE
NC
Enumeration date
08/22/2005
Last updated
03/02/2016
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