Provider Demographics
NPI:1750578407
Name:DISCHINGER-SMEDES, ROBERTA JEAN (MSN, APRN, BC, FNP)
Entity type:Individual
Prefix:MRS
First Name:ROBERTA
Middle Name:JEAN
Last Name:DISCHINGER-SMEDES
Suffix:
Gender:F
Credentials:MSN, APRN, BC, FNP
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Mailing Address - Street 1:50 INDUSTRIAL PARK RD
Mailing Address - Street 2:
Mailing Address - City:BANGOR
Mailing Address - State:MI
Mailing Address - Zip Code:49013-1246
Mailing Address - Country:US
Mailing Address - Phone:269-427-7937
Mailing Address - Fax:269-427-5180
Practice Address - Street 1:285 JAMES ST
Practice Address - Street 2:INTERCARE COMMUNITY HEALTH NETWORK
Practice Address - City:HOLLAND
Practice Address - State:MI
Practice Address - Zip Code:49424-1849
Practice Address - Country:US
Practice Address - Phone:616-218-3008
Practice Address - Fax:606-399-5055
Is Sole Proprietor?:No
Enumeration Date:2007-09-26
Last Update Date:2012-01-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4704180107363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIH06000126Medicare PIN