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General NPI Number Information
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NPI Number | 1760996375
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Entity Type | Individual
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Provider Name | CAROLYN SUE SMITH MSN-RN-CNS-CWOCN
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Gender | Female
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Dates
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Enumeration Date | 11/20/2017
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Last Update Date | 11/20/2017
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Provider Practice Location Address
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Address Line | 441 N WABASH AVE
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City | MARION
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State | IN
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Zip | 46952-2612
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Country | US
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Telephone | 765-660-6670
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Fax | 765-671-3392
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Provider Business Mailing Address
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Address Line | 441 N WABASH AVE
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City | MARION
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State | IN
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Zip | 46952-2612
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Country | US
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Telephone | 765-660-6670
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Fax | 765-671-3392
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WE0900X
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Taxonomy Name | Enterostomal Therapy Registered Nurse
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License Number | 28103859A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 163WW0000X
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Taxonomy Name | Wound Care Registered Nurse
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License Number | 28103859A
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License Number State | IN
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Taxonomy #3
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Taxonomy Code | 364SC1501X
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Taxonomy Name | Community Health/Public Health Clinical Nurse Specialist
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License Number | 28103859A
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License Number State | IN
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Taxonomy #4
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 28103859A
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License Number State | IN
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Taxonomy #5
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Taxonomy Code | 163WC2100X
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Taxonomy Name | Continence Care Registered Nurse
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License Number | 28103859A
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License Number State | IN
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