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Individual

AMY LOUISE SMITH- BASSETT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN

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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