Provider Demographics
NPI:1437348935
Name:SMITH, SUSAN GLASPIE (NP)
Entity Type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:GLASPIE
Last Name:SMITH
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:324 NEFF RD
Mailing Address - Street 2:
Mailing Address - City:GROSSE POINTE
Mailing Address - State:MI
Mailing Address - Zip Code:48230-1645
Mailing Address - Country:US
Mailing Address - Phone:313-417-3911
Mailing Address - Fax:
Practice Address - Street 1:324 NEFF RD
Practice Address - Street 2:
Practice Address - City:GROSSE POINTE
Practice Address - State:MI
Practice Address - Zip Code:48230-1645
Practice Address - Country:US
Practice Address - Phone:313-417-3911
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-20
Last Update Date:2008-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704198972363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIP35120092Medicare PIN