Individual
DEZARAE L SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
1321 11TH AVE, ALTOONA, PA 16601-3301
(914) 942-2411
(814) 943-6291
Mailing address
1321 11TH AVE, ALTOONA, PA 16601-3301
(914) 942-2411
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
SP032761
PA
Other
Enumeration date
04/23/2025
Last updated
04/23/2025
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