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Individual
JENNIFER ANN SMITH
Active
Individual
JENNIFER ANN SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT30132
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
079A6
BCBS NC
NC
05
—
7211861
—
NC
01
—
D3037
MEDCOST NC
NC
Enumeration date
08/01/2006
Last updated
04/02/2018
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