Provider Demographics
NPI:1689177610
Name:SMITH, MARIE EMILY BROBECK (DNP, RN, CPNP)
Entity Type:Individual
Prefix:DR
First Name:MARIE
Middle Name:EMILY BROBECK
Last Name:SMITH
Suffix:
Gender:F
Credentials:DNP, RN, CPNP
Other - Prefix:
Other - First Name:MARIE
Other - Middle Name:EMILY
Other - Last Name:BROBECK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DNP, CPNP
Mailing Address - Street 1:6054 N PANORAMA PARK DR
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85704-3938
Mailing Address - Country:US
Mailing Address - Phone:520-260-8600
Mailing Address - Fax:
Practice Address - Street 1:3043 W INA RD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85741-2107
Practice Address - Country:US
Practice Address - Phone:520-797-7070
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-15
Last Update Date:2018-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP11099363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics