Provider Demographics
NPI:1205599578
Name:S.D.S NP INTEGRATIVE HEALTH CARE LLC
Entity type:Organization
Organization Name:S.D.S NP INTEGRATIVE HEALTH CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:SHELBEE
Authorized Official - Middle Name:
Authorized Official - Last Name:SMOLEK
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:260-229-4239
Mailing Address - Street 1:1209 S 700 E
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA CITY
Mailing Address - State:IN
Mailing Address - Zip Code:46725-9034
Mailing Address - Country:US
Mailing Address - Phone:260-229-4239
Mailing Address - Fax:
Practice Address - Street 1:1209 S 700 E
Practice Address - Street 2:
Practice Address - City:COLUMBIA CITY
Practice Address - State:IN
Practice Address - Zip Code:46725-9034
Practice Address - Country:US
Practice Address - Phone:260-229-4239
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-14
Last Update Date:2021-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QS1201XAllopathic & Osteopathic PhysiciansFamily MedicineSleep MedicineGroup - Single Specialty