Provider Demographics
NPI:1861371692
Name:SMETANA, MARY SUSAN
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:SUSAN
Last Name:SMETANA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MARY
Other - Middle Name:SUSAN
Other - Last Name:KILLER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:216 N DENVER AVE
Mailing Address - Street 2:
Mailing Address - City:HASTINGS
Mailing Address - State:NE
Mailing Address - Zip Code:68901-5138
Mailing Address - Country:US
Mailing Address - Phone:402-462-5107
Mailing Address - Fax:402-462-5126
Practice Address - Street 1:PO BOX 637
Practice Address - Street 2:
Practice Address - City:OXFORD
Practice Address - State:NE
Practice Address - Zip Code:68967-0637
Practice Address - Country:US
Practice Address - Phone:308-824-3283
Practice Address - Fax:308-824-3356
Is Sole Proprietor?:No
Enumeration Date:2025-08-27
Last Update Date:2025-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE372600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion