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General NPI Number Information
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NPI Number | 1205599578
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Entity Type | Organization
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Legal Business Name | S.D.S NP INTEGRATIVE HEALTH CARE LLC
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Dates
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Enumeration Date | 10/14/2021
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Last Update Date | 11/24/2021
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Provider Practice Location Address
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Address Line | 1209 S 700 E
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City | COLUMBIA CITY
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State | IN
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Zip | 46725-9034
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Country | US
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Telephone | 260-229-4239
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Fax |
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Provider Business Mailing Address
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Address Line | 1209 S 700 E
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City | COLUMBIA CITY
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State | IN
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Zip | 46725-9034
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Country | US
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Telephone | 260-229-4239
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Fax |
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Authorized Official
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Title or Position | NURSE PRACTITIONER
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Name | SHELBEE SMOLEK
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Credential | APRN
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Telephone | 260-229-4239
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QS1201X
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Taxonomy Name | Sleep Medicine (Family Medicine) Physician
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License Number |
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License Number State |
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