Individual
MARY BETH SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2001 W 86TH ST, INDIANAPOLIS, IN 46260-1902
(317) 338-2345
Mailing address
8840 COMMERCE PARK PL STE E, INDIANAPOLIS, IN 46268-3129
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
71001380A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200391050
—
IN
Enumeration date
05/04/2006
Last updated
01/29/2015
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