Smith, Mary Bonnie
Smith, Mary Bonnie is an individual health care provider with primary practice located at 3643 W Front St Suite C, Traverse City MI 49684-7759. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Pediatrics, which is considered as her primary health care specialty. Smith, Mary Bonnie can be contacted via phone (231) 935-0614.Contact Information
Primary practice address
3643 W Front St Suite C
Traverse City MI 49684-7759
Phone: (231) 935-0614
Fax: (231) 935-0832
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Pediatrics | 363LP0200X | 4704077230 | Michigan |
Profile Details
| NPI number | 1588876254 |
|---|---|
| LBN Legal business name | Smith, Mary Bonnie |
| Credentials | Certified Pediatric Nurse Practitioner (CPNP) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 4th, 2007 |
| Last updated | Jul 8th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1588876254 | NPPES |
| Michigan | Other | 4704077230 | REGISTERED NURSE LICENSE |
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