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Individual
MATTHEW L SMITH
Active
Individual
MATTHEW L SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
R26377
NM
163WS0200X
School Registered Nurse
291816
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
36672548
—
NM
Enumeration date
10/29/2018
Last updated
06/10/2019
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