| NPI | 1720522493 |
|---|---|
| Former Name | SUSAN R SMITH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3010929) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OH APRN.CNP.019780) |
| Enumeration Date | 2016-12-14 |
| Last Update Date | 2022-11-07 |