Doctor Name: | MS. MARCY SUE SMITH |
NPI Number: | 1003946724 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | CRNP |
License Number: | TP006989B |
Business Practice Address: | 197 Division St Wilkes Barre, PA - 187063313 |
Business Phone Number: | 5702625078 |
Business Fax Number: | |
Mailing Address: | 159 N Memorial Hwy, SHAVERTOWN |
State: | PA |
Postal Code: | 187081124 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 03/06/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | TP006989B |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |