person
Mary Bonnie Smith, CPNP
Pediatric Nurse Practitioner in Traverse City, Michigan
NPI 1588876254

Mary Bonnie Smith is a Pediatric Nurse Practitioner based in Traverse City, MI and is specialized in Pediatrics. Mary Bonnie Smith practices in Traverse City, MI and has the professional credentials of CPNP. The NPI Number for Mary Bonnie Smith is 1588876254 and holds a License No. 4704077230 (Michigan).

The current practice location address for Mary Bonnie Smith is 3643 W Front St, Traverse City, MI and can be reached out via phone at 231-935-0614 and via fax at 231-935-0832.

Location: 3643 W Front St, Traverse City, MI, 49684-7759
person
Provider Profile Details
NPI Number
1588876254
Provider Name
Mary Bonnie Smith
Credential
CPNP
Provider Entity Type
Individual
Gender
Female
Address
3643 W Front St, Traverse City, MI, 49684-7759
Phone Number
231-935-0614
Fax Number
231-935-0832
Provider Enumeration Date
05/04/2007
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
4704077230 01 MI REGISTERED NURSE LICENSE
institution
Provider Business Practice Location Address Details
Address
3643 W Front St
City
State
Zip
49684-7759
Phone Number
231-935-0614
Fax Number
231-935-0832
person
Provider Business Mailing Address Details
Address
3643 W Front St
City
State
Zip
49684-7759
Phone Number
231-935-0614
Fax Number
231-935-0832
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Pediatrics
Taxonomy
License No.
4704077230 (Michigan)
Definition
Definition to come...
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