Provider Demographics
NPI:1699919217
Name:SMITH, SUSAN SCOTTI (CNM)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:SCOTTI
Last Name:SMITH
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:SUSAN
Other - Middle Name:ELLEN
Other - Last Name:SCOTTI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CNM
Mailing Address - Street 1:143 LONGWATER DRIVE
Mailing Address - Street 2:SOUTH SHORE MEDICAL CENTER
Mailing Address - City:NORWELL
Mailing Address - State:MA
Mailing Address - Zip Code:02061
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:141 LONGWATER DRIVE
Practice Address - Street 2:SOUTH SHORE MEDICAL CENTER
Practice Address - City:NORWELL
Practice Address - State:MA
Practice Address - Zip Code:02061
Practice Address - Country:US
Practice Address - Phone:781-878-5200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-04-27
Last Update Date:2023-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN239849367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife