Individual
AMY PITTLICK SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2170 SOUTH AVE, SOUTH LAKE TAHOE, CA 96150-7026
(530) 539-6620
(530) 539-6617
Mailing address
1111 EMERALD BAY RD, SOUTH LAKE TAHOE, CA 96150-6207
(530) 543-5659
(530) 541-8723
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
13943
CA
363LF0000X
Family Nurse Practitioner
APRN001842
NV
Other
Enumeration date
10/21/2005
Last updated
12/13/2018
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