Provider Demographics
NPI:1669847539
Name:SMB NURSE CONSULTANT SERVICE,PLLC
Entity Type:Organization
Organization Name:SMB NURSE CONSULTANT SERVICE,PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:MILNE
Authorized Official - Last Name:BARBER
Authorized Official - Suffix:
Authorized Official - Credentials:MSN,RN
Authorized Official - Phone:386-916-6071
Mailing Address - Street 1:PO BOX 803
Mailing Address - Street 2:
Mailing Address - City:EAST PALATKA
Mailing Address - State:FL
Mailing Address - Zip Code:32131-0803
Mailing Address - Country:US
Mailing Address - Phone:386-916-6071
Mailing Address - Fax:386-325-3597
Practice Address - Street 1:225 MORITANI POINT RD
Practice Address - Street 2:
Practice Address - City:EAST PALATKA
Practice Address - State:FL
Practice Address - Zip Code:32131-4010
Practice Address - Country:US
Practice Address - Phone:386-916-6071
Practice Address - Fax:386-325-3597
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-03
Last Update Date:2015-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN2612612251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care