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Individual
MARYJO SMITH
Active
Individual
MARYJO SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Taxonomy
Speciality
Code
Description
License number
State
163WX0106X
Occupational Health Registered Nurse
Primary
R076273
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
R076273
NURSING LICENSE
MD
Enumeration date
04/27/2020
Last updated
04/27/2020
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