Basic Information
Provider Information
NPI: 1538518071
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: PANT
FirstName: SMRITI
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: FNP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 501 LAPEER AVE
Address2:  
City: SAGINAW
State: MI
PostalCode: 486071203
CountryCode: US
TelephoneNumber: 9897596464
FaxNumber: 9893998233
Practice Location
Address1: 501 LAPEER AVE
Address2:  
City: SAGINAW
State: MI
PostalCode: 486071203
CountryCode: US
TelephoneNumber: 9897596464
FaxNumber: 9893998233
Other Information
ProviderEnumerationDate: 06/06/2016
LastUpdateDate: 04/09/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 04/09/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LF0000X4704284468MIY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily

No ID Information.


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