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Individual
MS. TARA SHANNON SMITH
Active
Individual
MS. TARA SHANNON SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
C.N.M.
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
0001146963
VA
176B00000X
Midwife
Primary
0024165986
VA
367A00000X
Advanced Practice Midwife
AC00911
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010061873
—
VA
05
—
010130484
—
VA
01
—
175079
ANTHEM
VA
01
—
2125746
UHC/MAMSI
VA
05
—
7002042
—
NC
01
—
75928N
SENTARA/OPTIMA
VA
Enumeration date
02/13/2006
Last updated
02/15/2012
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