Individual
MR. NICHOLAS GRANT SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
C.R.N.A.
Contact information
Practice address
2401 S 31ST ST, TEMPLE, TX 76504-7115
(254) 724-2111
Mailing address
2803 IRA YOUNG DR, APT 3111, TEMPLE, TX 76504-6323
(225) 202-3797
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
120081
LA
367500000X
Certified Registered Nurse Anesthetist
Primary
814527
TX
Other
Enumeration date
01/30/2012
Last updated
05/08/2012
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