MARY BONNIE SMITH (NPI# 1588876254) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588876254 |
| Entity Type | Individual |
| Full Name | MARY BONNIE SMITH |
| Credential | C.P.N.P. |
| Practice Address |
3643 W Front St Suite C Traverse City MI 49684-7759 |
| Practice Telephone | 2319350614 |
| Practice Fax Number | 2319350832 |
| Mailing Telephone | 2319350614 |
| Mailing Fax Number | 2319350832 |
| Enumeration Date | 2007-05-04 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
4704077230 | MI | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | REGISTERED NURSE LICENSE | 4704077230 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821604133 | Mary Smith | Technician | 3306 Cypress Ave, Cleveland, OH 44109-4935 | 2020-09-22 |
| 1275147209 | Mary Irene Smith | Technician | 490 Court St, Fort Gay, WV 25514-9304 | 2020-09-08 |
| 1679183560 | Mary Jean Smith | Counselor | 2105 Capurro Way Ste 270, Sparks, NV 89431-8518 | 2020-08-05 |
| 1346863016 | Mary Maegan Smith | Physical Therapy Assistant | 4545 State Highway 135 N, Jacksonville, TX 75766-6971 | 2020-05-28 |
| 1326668716 | Mary Smith | Adult Companion | 2546 Ne 11th Pl, Gainesville, FL 32641-4886 | 2020-04-25 |
| 1912534256 | Mary Margaret Smith | Dietitian, Registered | 756 Forest Dr, Mayville, WI 53050-1704 | 2020-03-26 |
| 1265074454 | Mary Elizabeth Smith | Nurse Practitioner | 1441 Ne 10th Ave # Aev, Payette, ID 83661-5420 | 2019-10-09 |
| 1477014686 | Mary Smith | Physical Therapy Assistant | 209 Laura Springs Dr, Salisbury, NC 28146-7216 | 2019-03-29 |
| 1578040341 | Mary Stefanie Smith | Marriage & Family Therapist | 17581 Via Sereno, Monte Sereno, CA 95030-3201 | 2018-07-25 |
| 1720588817 | Mary Smith | Home Health Aide | 5333 Dix St Ne, Washington, DC 20019-6664 | 2018-02-15 |
| Street Address |
3643 W FRONT ST SUITE C |
| City | TRAVERSE CITY |
| State | MI |
| Zip Code | 49684-7759 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487646923 | John J Gorman | Internal Medicine | 3643 W Front St, Suite C, Traverse City, MI 49684-7759 | 2005-08-19 |
| 1730208349 | Amy Lynn Ream | Specialist/Technologist | 3643 W Front St, Suite B, Traverse City, MI 49684-7759 | 2007-03-28 |
| 1831224765 | Curt Jeffrey Schubert | Internal Medicine | 3643 W Front St, Suite C, Traverse City, MI 49684-7759 | 2007-02-22 |
| 1528168895 | Northern Michigan Medicine and Pediatrics, Pllc | Pediatrics | 3643 W Front St, Suite C, Traverse City, MI 49684-7759 | 2006-09-25 |
| 1861430779 | Associates In Dermatology of Traverse City PC | Dermatology | 3643 W Front St, Traverse City, MI 49684-7759 | 2006-06-03 |
| 1770565384 | Jeffrey John Kelly | Dermatology | 3643 W Front St, Suite A, Traverse City, MI 49684-7759 | 2005-11-18 |
| 1871585174 | Margaret J Meeker | Pediatrics | 3643 W Front St, Suite C, Traverse City, MI 49684-7759 | 2005-08-22 |
| 1295727774 | Walter K Meeker | Internal Medicine | 3643 W Front St, Suite C, Traverse City, MI 49684 | 2005-08-19 |
| 1104818681 | Robert E Kuhn | Internal Medicine | 3643 W Front St, Suite C, Traverse City, MI 49684-7759 | 2005-08-19 |
| 1922090406 | Sherry L Small | Pediatrics | 3643 W Front St, Suite C, Traverse City, MI 49684-7759 | 2005-08-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124641758 | Karen Anne Paulosky | Registered Nurse | 226 S Madison St, Traverse City, MI 49684 | 2020-05-18 |
| 1891314795 | Jaclyn Elizabeth Sylvain | Student in an Organized Health Care Education/Training Program | Munson Family Practice Center, 1400 Medical Campus Drive, Traverse City, MI 49684 | 2020-04-10 |
| 1285282988 | Madelyn Drumm | Dietitian, Registered | 217 S. Madison St., Suite 3022, Traverse City, MI 49684 | 2019-08-27 |
| 1265917686 | Kacie Danielle Heading | Social Worker | 12719 S. West Bay Shore Drive, Suite 9, Traverse City, MI 49684 | 2018-10-02 |
| 1881178325 | Jacob White Ph.d., Pllc | Psychologist | 3537 W. Front Street, Suite F, Traverse City, MI 49684 | 2018-09-20 |
| 1144702572 | Constance Baab, Phd, Lmsw, Pllc | Social Worker | 3301 Veterans Drive Suite 127, Traverse City, MI 49684 | 2018-09-01 |
| 1346732880 | The Skin Cancer and Dermatology Center Plc | Dermatology | 1225 W Front St Ste 2, Traverse City, MI 49684 | 2018-05-31 |
| 1790283851 | Lisa Louise Kleyps | Massage Therapist | 3337 W. South Airport Road #2, Traverse City, MI 49684 | 2018-01-24 |
| 1114447646 | Brittany Alexandra Prior | Physical Therapist | 3899 W Front Sreet, Unit 3, Traverse City, MI 49684 | 2017-06-26 |
| 1568902963 | Jennifer Scott | Behavior Technician | 515 W 14th St Unit D, Traverse City, MI 49684 | 2017-03-03 |
| Find all providers in zip 49684 | ||||
| Taxonomy Code | 363LP0200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Pediatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710045661 | Alicia Classens | Nurse Practitioner | 5024 N Royal Dr, Kids Creek Children's Clinic, Traverse City, MI 49684-9230 | 2006-12-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851991061 | Sarah Elizabeth Barber | Nurse Practitioner | 12918 Lake Point Pass, Van Buren Twp, MI 48111-2243 | 2020-10-27 |
| 1730700881 | Kelsey Olinik | Nurse Practitioner | 22200 Barclay Dr, Novi, MI 48374-3874 | 2020-04-29 |
| 1467080705 | Jessica Nicole Heichel | Nurse Practitioner | 7729 Brass Creek Ct, Dexter, MI 48130-9384 | 2020-03-31 |
| 1114550506 | Katlyn Roberts | Nurse Practitioner | 60160 E 8 Mile Rd, South Lyon, MI 48178-9768 | 2020-02-13 |
| 1093351595 | Emily Janina Jamett | Nurse Practitioner | 31815 Southfield Rd Ste 10, Beverly Hills, MI 48025-5471 | 2019-11-20 |
| 1508410747 | Clorissa Diedrich | Nurse Practitioner | 829 N Center Ave Ste 130, Gaylord, MI 49735-1684 | 2019-07-25 |
| 1255895355 | Jessica Lynn Kata | Nurse Practitioner | 19229 Mack Ave Ste 28, Grosse Pointe Woods, MI 48236-2857 | 2019-01-23 |
| 1467934679 | Anita Lynn Riddle | Nurse Practitioner | 100 W. Vanburen Street, Battle Creek, MI 49017 | 2018-09-04 |
| 1285120634 | Alexandra Danko | Nurse Practitioner | 5500 Auto Club Dr Ste 160, Dearborn, MI 48126-2779 | 2018-07-09 |
| 1417442617 | Shelby Fredricks | Nurse Practitioner | 1205 S Mission St Ste 4, Mount Pleasant, MI 48858-3939 | 2018-06-29 |
| Find all providers with the same taxonomy | ||||
| City | TRAVERSE CITY |
| Zip Code | 49684 |
Please comment or provide details below to improve the information on MARY BONNIE SMITH.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.