Provider Demographics
NPI:1427065820
Name:SMITH, SUSAN ELIZABETH (RN, APRN)
Entity type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:ELIZABETH
Last Name:SMITH
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Gender:F
Credentials:RN, APRN
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Mailing Address - Street 1:4801 EAST LINWOOD BLVD
Mailing Address - Street 2:PULMONARY MEDICINE #111
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64128
Mailing Address - Country:US
Mailing Address - Phone:816-861-4700
Mailing Address - Fax:816-922-3323
Practice Address - Street 1:4801 E LINWOOD BLVD
Practice Address - Street 2:#111
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64128-2226
Practice Address - Country:US
Practice Address - Phone:816-861-4700
Practice Address - Fax:816-922-3323
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2007-07-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO079123364SA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SA2200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistAdult Health