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Individual
HEATHER L SMITH
Active
Individual
HEATHER L SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10001127A
IN
363A00000X
Physician Assistant
3023
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000633571
ANTHEM
IN
05
—
918328
—
AZ
Enumeration date
08/24/2005
Last updated
11/15/2022
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