Individual
JEREMY SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
10009 CHADBOURNE RD, FORT WORTH, TX 76244-9589
(304) 483-0212
Mailing address
501 COLLEGE AVE, FORT WORTH, TX 76104-2270
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
1031928
TX
163W00000X
Registered Nurse
382473
OH
Other
Enumeration date
11/04/2022
Last updated
11/04/2022
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