Provider Demographics
NPI:1275412306
Name:SMIT, SUSANNA J LOUISA
Entity type:Individual
Prefix:
First Name:SUSANNA
Middle Name:J LOUISA
Last Name:SMIT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2407 BILL SMITH RD
Mailing Address - Street 2:
Mailing Address - City:CONROE
Mailing Address - State:TX
Mailing Address - Zip Code:77384-4407
Mailing Address - Country:US
Mailing Address - Phone:832-270-8030
Mailing Address - Fax:832-270-8030
Practice Address - Street 1:2407 BILL SMITH RD
Practice Address - Street 2:
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77384-4407
Practice Address - Country:US
Practice Address - Phone:832-270-8030
Practice Address - Fax:832-270-8030
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-02
Last Update Date:2025-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX817147163WN1003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WN1003XNursing Service ProvidersRegistered NurseNutrition Support