Individual
MS. SUSAN A. SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
A.N.P.
Contact information
Practice address
2845 CAPITAL AVE SW, SUITE 302, BATTLE CREEK, MI 49015-4185
(269) 979-6333
(269) 979-6335
Mailing address
2845 CAPITAL AVE SW, SUITE 302, BATTLE CREEK, MI 49015-4185
(269) 979-6333
(269) 979-6335
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
0651332
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0651332
LICENSE
MI
01
—
1750472734
GROUP NPI NUMBER
MI
01
—
381916607
TAX ID
MI
01
—
CW405106
SUPERVISOR WILMANSKI
MI
Enumeration date
11/07/2006
Last updated
11/27/2023
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