Provider Demographics
NPI:1154441251
Name:SMITH, SUSAN BARRINGER (APRN, FNP-C, PNP-C)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:BARRINGER
Last Name:SMITH
Suffix:
Gender:F
Credentials:APRN, FNP-C, PNP-C
Other - Prefix:
Other - First Name:SUSAN
Other - Middle Name:MARIE
Other - Last Name:BARRINGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CPNP
Mailing Address - Street 1:180 NORTH 5TH STREET
Mailing Address - Street 2:BENSON DERMATOLOGY AND SKIN CANCER, LLC
Mailing Address - City:PONCHATOULA
Mailing Address - State:LA
Mailing Address - Zip Code:70454
Mailing Address - Country:US
Mailing Address - Phone:985-370-7546
Mailing Address - Fax:985-370-7765
Practice Address - Street 1:180 NORTH 5TH STREET
Practice Address - Street 2:BENSON DERMATOLOGY AND SKIN CANCER, LLC
Practice Address - City:PONCHATOULA
Practice Address - State:LA
Practice Address - Zip Code:70454
Practice Address - Country:US
Practice Address - Phone:985-370-7546
Practice Address - Fax:985-370-7765
Is Sole Proprietor?:No
Enumeration Date:2007-03-30
Last Update Date:2013-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA05147363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1009407Medicaid