Provider Demographics
NPI:1689800310
Name:SMITH, NANCY A (RNBSN)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:A
Last Name:SMITH
Suffix:
Gender:F
Credentials:RNBSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:639 GRANITE ST
Mailing Address - Street 2:
Mailing Address - City:BRAINTREE
Mailing Address - State:MA
Mailing Address - Zip Code:02184-5366
Mailing Address - Country:US
Mailing Address - Phone:781-356-8017
Mailing Address - Fax:
Practice Address - Street 1:16 TOWN CRIER DR
Practice Address - Street 2:
Practice Address - City:BRATTLEBORO
Practice Address - State:VT
Practice Address - Zip Code:05301-8669
Practice Address - Country:US
Practice Address - Phone:802-258-4623
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-09
Last Update Date:2009-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT0260018627163WA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA0400XNursing Service ProvidersRegistered NurseAddiction (Substance Use Disorder)