Individual
ALISSA DANIELLE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
3132 OLD JACKSONVILLE RD, SUITE 200, SPRINGFIELD, IL 62704-7400
(217) 862-0800
Mailing address
PO BOX 3428, SPRINGFIELD, IL 62708-3428
(800) 577-5368
(217) 757-7550
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
209007694
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
041-336573
RN LICENSE
IL
01
—
2009006380
ANCC CERTIFICATION
IL
Enumeration date
07/22/2009
Last updated
03/20/2023
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