Provider Demographics
NPI:1295717882
Name:DE SMET, PATRICIA ANN (CRNP MS CAC)
Entity type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:ANN
Last Name:DE SMET
Suffix:
Gender:F
Credentials:CRNP MS CAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2641 S SILVER BEACH RD
Mailing Address - Street 2:
Mailing Address - City:COEUR D ALENE
Mailing Address - State:ID
Mailing Address - Zip Code:83814-7769
Mailing Address - Country:US
Mailing Address - Phone:208-667-3935
Mailing Address - Fax:208-667-2988
Practice Address - Street 1:1000 W GARDEN AVE
Practice Address - Street 2:
Practice Address - City:COEUR D ALENE
Practice Address - State:ID
Practice Address - Zip Code:83814-2161
Practice Address - Country:US
Practice Address - Phone:208-769-7818
Practice Address - Fax:208-769-3292
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDACC103171100000X
IDNP111A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered171100000XOther Service ProvidersAcupuncturist
Not Answered363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily