Provider Demographics
NPI:1669806451
Name:NESMITH, SUZANNE L (NP-C)
Entity type:Individual
Prefix:
First Name:SUZANNE
Middle Name:L
Last Name:NESMITH
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:100 N ACADEMY AVE
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17822-4903
Mailing Address - Country:US
Mailing Address - Phone:570-271-6144
Mailing Address - Fax:570-271-6578
Practice Address - Street 1:890 POPLAR CHURCH RD
Practice Address - Street 2:SUITE 503
Practice Address - City:CAMP HILL
Practice Address - State:PA
Practice Address - Zip Code:17011-2250
Practice Address - Country:US
Practice Address - Phone:717-972-7120
Practice Address - Fax:717-972-7121
Is Sole Proprietor?:No
Enumeration Date:2013-08-28
Last Update Date:2020-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP012983363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner