Individual
AMY LOUISE SMITH- BASSETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
74 PARK RD STE 2, WEST HARTFORD, CT 06119-1898
(860) 533-0179
Mailing address
315 E CENTER ST, MANCHESTER, CT 06040-5251
(860) 533-0179
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
041299719
IL
367A00000X
Advanced Practice Midwife
Primary
000333
CT
367A00000X
Advanced Practice Midwife
209004736
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009003336
—
CT
01
—
041299719
PROFESSIONAL NURSE LISCEN
IL
01
—
209004736
ADVANCED PRACTICE NURSE
IL
01
—
309002077
CONTROLLED SUBSTANCE
IL
Enumeration date
08/13/2006
Last updated
09/10/2019
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